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CPT 43312: Esophageal Reconstruction with Tracheoesophageal Fistula Repair
CPT code 43312 denotes thoracic surgical reconstruction of an esophageal defect, including incision and repair of a tracheoesophageal fistula when present. This operative procedure is performed through a chest incision (thoracotomy) and is relevant to thoracic surgery, trauma repair, and complex esophageal disease management. The code captures care that often requires multidisciplinary perioperative support and inpatient hospital resources.
Key payers covered in this national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for CPT code 43312, typical sites of service, common modifiers and billing considerations provided in the input, and which payers are commonly involved in coverage decisions. The publication summarizes benchmarks where available, highlights policy and coding guidance relevant to thoracic esophageal reconstruction, and outlines clinical scenarios that commonly generate use of this code.
Intended for coders, billing managers, and clinical administrators, the summary equips readers with the essential national-level information needed to identify when CPT code 43312 applies and what operational settings and payer relationships are typically implicated. Data not available in the input are noted explicitly.
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Billing Code Overview
CPT code 43312 describes surgical repair or reconstruction of an esophageal defect performed through a chest incision (thoracotomy). The procedure includes incision and repair of a fistula between the trachea and esophagus when present.
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Service type: Thoracic surgical reconstruction of the esophagus, including tracheoesophageal fistula repair
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Typical site of service: Inpatient or outpatient hospital setting with thoracic operative capability (thoracotomy/chest incision)
Data not available in the input.