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CPT 43100: Excision of Cervical Esophageal Lesion
CPT code 43100 designates an open surgical excision of an esophageal lesion through a neck (cervical) incision. This operative approach is used when lesions in the cervical esophagus require direct access for removal and can involve management of both benign and malignant pathology. The code is relevant nationally for surgical specialties that manage esophageal disease and for payers that cover operative care in inpatient and outpatient surgical settings.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when a cervical esophageal approach is used and an outline of typical sites of service. The publication also provides benchmarking and policy-oriented content including utilization benchmarks, common payer coverage considerations, and coding practice observations where available.
This summary is intended to give clinicians, billing professionals, and policy analysts a concise reference to CPT code 43100, its clinical role, and the payer landscape for national coverage and reimbursement discussions. Data not available in the input will be noted in specific sections of the full publication.
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Billing Code Overview
CPT code 43100 describes a surgical procedure in which the provider makes an incision in the neck to remove a lesion from the esophagus. This procedure involves direct, open access to the cervical esophagus through a neck incision and is performed to excise benign or malignant lesions that are accessible via the cervical approach.
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Service type: Open surgical excision of an esophageal lesion via cervical incision
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Typical site of service: Hospital operating room or ambulatory surgery center