43283 Lap esoph lengthening
What 43283 is
CMS fee schedule short descriptor: Lap esoph lengthening.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 43283 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 2.88 | 0.64 | 0.73 | 4.25 | $141.95 |
| Facility (hospital, ASC) | 2.88 | 0.64 | 0.73 | 4.25 | $141.95 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Add-on code: global period of the primary procedure applies.
Medically Unlikely Edit (MUE)
Medicare caps 43283 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 43283? These codes are bundled into it
43283 is a Column 1 code in 21 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11001 | Dbrdmt ecz/infct skn ea addl | 1 - modifier may bypass | Check pair |
11004 | Dbrdmt skin xtrnl gent&per | 1 - modifier may bypass | Check pair |
11005 | Dbrdmt skin abdominal wall | 1 - modifier may bypass | Check pair |
11006 | Dbrdmt skin xtrnl gent per | 1 - modifier may bypass | Check pair |
11042 | Dbrdmt subq tis 1st 20sqcm/< | 1 - modifier may bypass | Check pair |
11043 | Dbrdmt musc&/fsca 1st 20/< | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 1 - modifier may bypass | Check pair |
11045 | Dbrdmt subq tiss each addl | 1 - modifier may bypass | Check pair |
11046 | Dbrdmt musc&/fsca ea addl | 1 - modifier may bypass | Check pair |
11047 | Dbrdmt bone each addl | 1 - modifier may bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
49082 | Abd paracentesis | 1 - modifier may bypass | Check pair |
49083 | Abd paracentesis w/imaging | 1 - modifier may bypass | Check pair |
49084 | Peritoneal lavage | 1 - modifier may bypass | Check pair |
49400 | Air injection into abdomen | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
97597 | Dbrdmt opn wnd 1st 20 cm/< | 1 - modifier may bypass | Check pair |
97598 | Dbrdmt opn wnd addl 20cm/< | 1 - modifier may bypass | Check pair |
97602 | Wound(s) care non-selective | 1 - modifier may bypass | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.