2025 CPT code 43101
(Active) Effective Date: N/A Revision Date: N/A Surgery - Esophageal Procedures Digestive System Feed
Excision of an esophageal lesion with primary repair through a thoracic or abdominal approach.
Modifiers 22 (increased procedural services), 51 (multiple procedures), 59 (distinct procedural service), and others may be applicable depending on the specific circumstances.
Surgical excision and repair of an esophageal lesion are medically necessary when less invasive treatments fail or are inappropriate, and the lesion causes significant symptoms (e.g., dysphagia, bleeding, obstruction). The decision regarding the surgical approach (thoracic or abdominal) will depend on the location and size of the lesion.
The surgeon is responsible for all aspects of the procedure, from prepping the patient and making the incision to excising the lesion, repairing the esophagus, and closing the incision.
In simple words: The doctor removes a damaged or diseased area in the esophagus (the tube connecting the mouth to the stomach) through an incision in the chest or abdomen.The esophagus is then repaired with stitches.
This CPT code, 43101, encompasses the surgical excision of a lesion from the esophagus, followed by primary repair of the esophageal wall.The procedure is performed via either a thoracic or abdominal incision.The surgeon carefully dissects the tissues to expose the esophagus, identifies and removes the lesion, and then meticulously repairs the esophageal wall in layers using sutures. The skin incision is then closed.This code does not include wide excisions of malignant lesions involving a cervical approach or those requiring additional procedures like laryngectomy or neck dissection.
Example 1: A 60-year-old male presents with a benign esophageal stricture causing dysphagia.The surgeon performs a 43101 procedure via a right thoracotomy to excise the stricture and perform a primary anastomosis., A 45-year-old female presents with a leiomyoma of the mid-esophagus causing intermittent bleeding.A laparotomy is performed, the leiomyoma is resected, and the esophageal wall is repaired using 43101., A 72-year-old male has a small esophageal perforation following an endoscopic procedure.An emergency laparotomy and repair using 43101 are performed.
* Preoperative diagnosis and justification for surgery.* Operative report detailing the approach (thoracic or abdominal), lesion characteristics (size, location, histology), repair technique, and complications.* Pathology report confirming the nature of the excised lesion.* Postoperative course notes documenting recovery and any complications.* Imaging studies (e.g., endoscopy, CT scan) showing the lesion before and after surgery.
** The selection of this code requires careful consideration of the location and extent of the lesion, the approach used, and any additional procedures performed.Always refer to the latest CPT coding guidelines and consult with a coding expert if needed.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:General Surgery, Thoracic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center