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    OpenPayerBilling CodesRepair Procedures on the EsophagusCPT cpt-43328-thoracic-fundoplasty-fundoplication-chest-approach
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    CPT 43328: Partial or Complete Fundoplasty via Thoracic Incision

    Medicare pays $1067 on average nationally for this procedure.

    CPT code 43328 describes a surgical procedure performing a partial or complete fundoplasty by wrapping the upper stomach around the lower esophagus via a chest (thoracic) incision; this is a surgical antireflux procedure typically performed in an operating room or thoracic surgery suite and represents an open or thoracotomy approach to correcting gastroesophageal reflux or hiatal hernia-related problems.

    For related coverage guidance, see recent payer policy updates: Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders, Esophagogastroduodenoscopy (EGD) Coverage Policy, Radiofrequency Therapy for Fecal Incontinence.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with symptomatic gastroesophageal reflux disease (GERD) or a hiatal hernia refractory to optimal medical therapy, presenting with chronic heartburn, regurgitation, or aspiration. Preoperative evaluation includes upper endoscopy, esophageal pH monitoring, esophageal manometry, and chest/abdominal imaging to assess anatomy and motility. The patient is optimized medically and cleared for general anesthesia. The surgeon performs a partial or complete fundoplasty via a transthoracic approach through a chest incision to reinforce the lower esophageal sphincter and reduce reflux; intraoperative steps include mobilization of the gastric fundus, creation of a 270–360° wrap (partial or complete), repair of a concurrent hiatal defect if present, and intraoperative testing of wrap tension. Postoperative workflow includes recovery in PACU, pain control, early ambulation, diet advancement from liquids to soft diet, and outpatient follow-up with activity and dietary restrictions. Typical site of service is an inpatient or ambulatory surgical hospital setting with thoracic surgery capabilities; the service type is a thoracic surgical procedure performed through a chest incision.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    43280Laparoscopy, surgical, esophagomyotomy, including fundoplasty, when performedPerformed via laparoscopic abdominal approach; alternative to transthoracic 43328.
    43282Laparoscopy, surgical, Heller myotomy; with partial fundoplicationOften performed with fundoplasty for achalasia when done laparoscopically instead of thoracotomy.
    43281Laparoscopy, surgical, Heller myotomy; without fundoplicationRelated esophageal motility surgery that may precede or accompany fundic procedures depending on diagnosis.
    43288Laparoscopy, surgical, revision of previous fundoplicationUsed when reoperation is required for failed or slipped fundoplication; may follow index 43328.
    43289Laparoscopy, surgical, reduction of paraesophageal hernia, repair of diaphragmatic defect, and fundoplicationPerformed when hiatal hernia repair and fundoplasty are done via minimally invasive approach; clinical alternative or complement.

    Related Modifiers

    13 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Showing 1–10 of 13

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207T00000X
    207RH0000X
    2086S0105X
    332S00000X
    2080P0216X
    333300000X
    2081P2900X
    133V00000X

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Radiofrequency Therapy for Fecal IncontinenceCigna2026-10-15
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    High-Resolution Anoscopy (HRA)Premera Bluecross2026-10-01
    Gastroesophageal and Gastrointestinal (GI) Services and ProceduresColorado Rocky Mountain Health Plans2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01

    Related Codes

    CPT-43300-ESOPHAGEAL-RECONSTRUCTION-CERVICAL-APPROACH

    CPT 43300: Esophageal Repair or Reconstruction via Cervical Incision

    CPT-43305-ESOPHAGEAL-REPAIR-CERVICAL-APPROACH-TRACHEOESOPHAGEAL-FISTULA-REPAIR

    CPT 43305: Esophageal Repair via Cervical Approach

    CPT-43310-ESOPHAGEAL-RECONSTRUCTION-THORACOTOMY

    CPT 43310: Esophageal Repair or Reconstruction via Thoracotomy

    CPT-43312-ESOPHAGEAL-RECONSTRUCTION-TRACHEOESOPHAGEAL-FISTULA-REPAIR

    CPT 43312: Esophageal Reconstruction and Tracheoesophageal Fistula Repair

    CPT-43313-CONGENITAL-ESOPHAGEAL-RECONSTRUCTION-THORACOTOMY

    CPT 43313: Repair of Congenital Esophageal Defect via Thoracotomy

    CPT-43314-CONGENITAL-ESOPHAGEAL-REPAIR-THORACOTOMY

    CPT 43314: Reconstruction of Congenital Esophageal Defect via Thoracotomy

    CPT-43320-LOWER-ESOPHAGUS-UPPER-STOMACH-REPAIR-OPEN-SURGERY

    CPT 43320: Plastic Repair of Lower Esophagus and Upper Stomach

    CPT-43325-DISTAL-ESOPHAGUS-REPAIR-WITH-FUNDIC-PATCH

    CPT 43325: Repair of Distal Esophagus with Fundic Patch

    CPT-43327-FUNDOPLASTY-OPEN-FUNDOPLICATION-ABDOMINAL-APPROACH

    CPT 43327: Partial or Complete Fundoplasty, Abdominal Approach

    CPT-43330-ESOPHAGEAL-REPAIR-ABDOMINAL-APPROACH

    CPT 43330: Open Abdominal Esophageal Repair (Flap Creation and Suturing)

    Showing 1–10 of 30

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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