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CPT code 43202: Esophageal biopsy, flexible transoral scope2026 Medicare rate & RVUs in Oklahoma

Flexible esophagoscopy with forceps sampling of esophageal tissue is reported when examination is confined to the esophagus and tissue diagnosis is needed.

CMS RVU26DEffective Oct 1, 2026One payment locality2.4K Medicare services in 2024

In Oklahoma, Medicare pays $356.25 for 43202 in the office and $88.41 when it’s performed in a hospital or facility.

$356.25Office (non-facility)
$88.41Hospital or facility
−9.4%vs the national office rate ($393.13)

Check a contract rate as a % of Medicare · 43202 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 43202 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Oklahoma
  2. What 43202 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 43202 covers

A flexible scope is passed through the mouth to inspect the esophagus, and tissue is collected for examination, typically with biopsy forceps. Gastroenterologists and other physicians trained in endoscopy may perform it in an office or an endoscopy facility. Common reasons include sampling an abnormal esophageal area, such as inflamed or suspicious mucosa. The service includes one or multiple biopsies during the examination.

Choose this code when the procedure is limited to the esophagus; if the examination extends into the stomach or duodenum, select the applicable upper endoscopy code instead. Document the esophageal findings, biopsy location, and sampling performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy-family pricing applies. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Oklahoma compares for 43202

Across 109 of 109 payment localities, the office rate for 43202 runs from $343.20 in Arkansas to $541.91 in San Benito County, CA. Oklahoma pays $356.25. The RVUs are the same everywhere; the geographic indexes change the dollars.

43202 in Oklahoma vs other payment areas
  1. Oklahoma · this page$356.25
  2. Los Angeles, CA · California$453.46+$97.21
  3. Washington, DC area · District of Columbia$455.69+$99.44
  4. Miami, FL · Florida$417.38+$61.13
  5. Chicago, IL · Illinois$404.25+$48.00
  6. Manhattan, NY · New York$454.29+$98.04
  7. Alaska · Alaska$439.49+$83.24

Other areas in Oklahoma first, then benchmark localities. Bars start at $0.

Every other payment area

43202 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$348.83$86.39
ArkansasArkansas$343.20$85.55
ArizonaArizona$381.89$91.25
Bakersfield, CACalifornia$423.13$94.40
Chico, CACalifornia$422.51$93.77
El Centro, CACalifornia$422.54$93.81
Fresno, CACalifornia$422.51$93.77
Hanford, CACalifornia$422.51$93.77

43202 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$343.20

$482.21

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
43202 office rate range by state
State / territoryOffice rate rangeLocalities
AK$439.491
AL$348.831
AR$343.201
AZ$381.891
CA$422.51–$541.9129
CO$413.391
CT$421.131
DC$455.691
DE$388.741
FL$382.14–$417.383
GA$358.84–$399.992
GU$435.391
HI$435.391
IA$360.851
ID$363.031
IL$368.37–$407.854
IN$365.431
KS$357.971
KY$355.901
LA$354.88–$374.612
MA$410.09–$458.682
MD$397.07–$455.693
ME$364.08–$387.572
MI$365.32–$386.392
MN$397.761
MO$347.41–$377.303
MS$345.431
MT$393.111
NC$368.491
ND$388.961
NE$363.361
NH$405.781
NJ$426.41–$449.942
NM$367.151
NV$392.291
NY$374.55–$465.105
OH$364.471
OK$356.251
OR$389.73–$428.862
PA$365.68–$409.022
PR$396.651
RI$404.331
SC$367.001
SD$388.471
TN$359.851
TX$362.93–$411.588
UT$372.611
VA$385.46–$455.692
VI$396.651
VT$386.361
WA$409.67–$469.562
WI$374.411
WV$352.921
WY$391.301

See 43202 in every payment locality

How the 43202 rate is calculated

Each of 43202’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 43202

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.68

1.68 RVUs× 1.000 GPCI

Practice expense9.88

9.88 RVUs× 1.000 GPCI

Malpractice0.21

0.21 RVUs× 1.000 GPCI

Adjusted RVUs

11.7700

Conversion factor

$33.4009

Medicare rate

$393.13

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Oklahoma inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,142

Code
43202
Physician work
1.68
Practice expense
9.88
Malpractice
0.21

GPCI2026.csv

86

Locality
Oklahoma
Physician work
1.000
Practice expense
0.893
Malpractice
0.777
Office calculation for 43202 in Oklahoma
ComponentRVULocality factorAdjusted
Physician work1.68× 1.0001.6800
Practice expense9.88× 0.8938.8228
Malpractice0.21× 0.7770.1632
Total RVUs10.6660
Conversion factor× 33.4009

Office rate, Oklahoma$356.25

Office: (1.68 × 1 + 9.88 × 0.893 + 0.21 × 0.777) × $33.4009 = $356.25

Facility: (1.68 × 1 + 0.9 × 0.893 + 0.21 × 0.777) × $33.4009 = $88.41

Open 43202 in the RVU calculator

Payment rules and modifiers for 43202

The CMS indicators that decide how 43202 is paid alongside other services.

CMS payment indicators · 43202

Esophageal biopsy, flexible transoral scope

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

43202 without 51 · national office

$393.13

Esophageal biopsy, flexible transoral scope

43202-51 · Second procedure: 50%

$196.57

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 43202

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 43202
CodeHow it relatesOffice range, Oklahoma
Used instead
43200Esophagoscopy, flexible scope with brushingsEsophageal brushing provides cytology sampling rather than forceps tissue biopsy.$260.33
43232Esophageal EUS, EUS-guided needle samplingUses ultrasound-guided needle sampling of an esophageal target rather than routine mucosal forceps biopsy.No office rate
43235Upper GI endoscopy, diagnostic, brushings or washingsUpper endoscopy is used when the examination extends beyond the esophagus; it is not this esophageal biopsy service.$294.49

How 43202 has changed in Oklahoma

43202 · Office / nonfacility

$356.25

Effective 2026-10-01

The base rate is $51.01 higher than on 2025-10-01, moving from $305.24 to $356.25 (16.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $305.24changed to$356.25

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.72 changed to 1.68
    • Practice expense RVU 8.46 changed to 9.88
    • Malpractice RVU 0.22 changed to 0.21
    • Practice expense GPCI 0.891 changed to 0.893
    • Malpractice GPCI 0.813 changed to 0.777

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $321.81changed to$305.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.71 changed to 8.46
    • Malpractice RVU 0.23 changed to 0.22

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $316.56changed to$321.81

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $329.62changed to$316.56

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.83 changed to 8.71
    • Practice expense GPCI 0.886 changed to 0.891
    • Malpractice GPCI 0.798 changed to 0.813

  5. January 1, 2023

    RVU23A

    $343.80changed to$329.62

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.12 changed to 8.83
    • Practice expense GPCI 0.881 changed to 0.886
    • Malpractice GPCI 0.782 changed to 0.798

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $340.84changed to$343.80

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.94 changed to 9.12
    • Malpractice RVU 0.22 changed to 0.23

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $315.17changed to$340.84

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.69 changed to 8.94
    • Malpractice RVU 0.23 changed to 0.22
    • Practice expense GPCI 0.886 changed to 0.881
    • Malpractice GPCI 0.868 changed to 0.782

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $301.46changed to$315.17

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.19 changed to 7.69
    • Malpractice RVU 0.25 changed to 0.23
    • Practice expense GPCI 0.891 changed to 0.886
    • Malpractice GPCI 0.954 changed to 0.868

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $288.00changed to$301.46

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.77 changed to 7.19
    • Malpractice RVU 0.26 changed to 0.25

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $283.47changed to$288.00

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.74 changed to 6.77
    • Practice expense GPCI 0.882 changed to 0.891
    • Malpractice GPCI 0.900 changed to 0.954

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $329.97changed to$283.47

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.82 changed to 1.72
    • Practice expense RVU 8.22 changed to 6.74
    • Malpractice RVU 0.27 changed to 0.26
    • Practice expense GPCI 0.872 changed to 0.882
    • Malpractice GPCI 0.845 changed to 0.900

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $333.96changed to$329.97

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.29 changed to 8.22
    • Malpractice RVU 0.29 changed to 0.27

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $332.30changed to$333.96

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $325.92changed to$332.30

    • Conversion factor 35.8228 changed to 35.7547
    • Work RVU 1.80 changed to 1.82
    • Practice expense RVU 8.20 changed to 8.29
    • Malpractice RVU 0.27 changed to 0.29
    • Practice expense GPCI 0.864 changed to 0.872
    • Malpractice GPCI 0.790 changed to 0.845

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $266.09changed to$325.92

    • Conversion factor 34.0230 changed to 35.8228
    • Work RVU 1.89 changed to 1.80
    • Practice expense RVU 6.68 changed to 8.20
    • Malpractice RVU 0.29 changed to 0.27
    • Practice expense GPCI 0.856 changed to 0.864
    • Malpractice GPCI 0.734 changed to 0.790

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $266.09

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$356.25$88.41RVU26D
2026-07-01$356.25$88.41RVU26C
2026-04-01$356.25$88.41RVU26B
2026-01-01$356.25$88.41RVU26A
2025-10-01$305.24$93.70RVU25D
2025-07-01$305.24$93.70RVU25C
2025-04-01$305.24$93.70RVU25B
2025-01-01$305.24$93.70RVU25A
2024-10-01$321.81$96.40RVU24D
2024-07-01$321.81$96.40RVU24C
2024-04-01$321.81$96.40RVU24B
2024-03-09$321.81$96.40RVU24AR
2024-01-01$316.56$94.83RVU24A
2023-10-01$329.62$96.93RVU23D
2023-07-01$329.62$96.93RVU23C
2023-04-01$329.62$96.93RVU23B
2023-01-01$329.62$96.93RVU23A
2022-10-01$343.80$98.37RVU22D
2022-07-01$343.80$98.37RVU22C
2022-04-01$343.80$98.37RVU22B
2022-01-01$343.80$98.37RVU22A
2021-10-01$340.84$98.30RVU21D
2021-07-01$340.84$98.30RVU21C
2021-04-01$340.84$98.30RVU21B
2021-01-01$340.84$98.30RVU21A
2020-10-01$315.17$101.89RVU20D
2020-07-01$315.17$101.89RVU20C
2020-04-01$315.17$101.89RVU20B
2020-01-01$315.17$101.89RVU20A
2019-10-01$301.46$103.66RVU19D
2019-07-01$301.46$103.66RVU19C
2019-04-01$301.46$103.66RVU19B
2019-01-01$301.46$103.66RVU19A
2018-10-01$288.00$104.21RVU18D
2018-07-01$288.00$104.21RVU18C
2018-04-01$288.00$104.21RVU18B
2018-01-01$288.00$104.21RVU18AR1
2017-10-01$283.47$103.36RVU17D
2017-07-01$283.47$103.36RVU17C
2017-04-01$283.47$103.36RVU17B
2017-01-01$283.47$103.36RVU17A
2016-10-01$329.97$107.36RVU16D
2016-07-01$329.97$107.36RVU16C
2016-04-01$329.97$107.36RVU16B
2016-01-01$329.97$107.36RVU16A
2015-10-01$333.96$109.30RVU15D
2015-07-01$333.96$109.30RVU15C
2015-04-01$332.30$108.75RVU15B
2015-01-01$332.30$108.75RVU15A
2014-10-01$325.92$106.79RVU14D
2014-07-01$325.92$106.79RVU14C
2014-04-01$325.92$106.79RVU14B
2014-01-01$325.92$106.79RVU14A
2013-10-01$266.09$109.12RVU13D
2013-07-01$266.09$109.12RVU13C
2013-04-01$266.09$109.12RVU13B
2013-01-01$266.09$109.12RVU13AR

Price 43202 for an earlier date of service

Where the Oklahoma rate applies

Oklahoma is a Medicare payment area, not a city. Our Census mapping connects it to 846 cities and communities in Oklahoma. Some span more than one payment area; confirm with the service ZIP.

  • Lahoma
  • Achille
  • Ada
  • Adair
  • Adams
  • Adamson
  • Addington
  • Afton

Browse all communities in Oklahoma

43202 billing questions

How is this different from code 43200?

Code 43202 involves tissue biopsy, generally collected with forceps. Code 43200 describes esophageal brushing for cytology rather than forceps tissue sampling.

Can a separate biopsy code be reported for the same esophageal samples?

The biopsy is included in this service. Do not separately report another biopsy service for the same sampling.

When should an EGD code be selected instead?

Use an applicable EGD code when the examination includes the stomach or duodenum. This code is for examination and biopsy confined to the esophagus.

How does CMS price related endoscopies performed in the same session?

CMS applies endoscopy-family pricing when related endoscopies are performed together. The 0-day global period includes same-day preoperative and postoperative care.

Which surgical modifiers are appropriate?

Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 43202PPRRVU2026_Oct_nonQPP.csv, line 5,142 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)

Open CMS sourceHow we calculate rates

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