CPT code 43211: Esophageal resection, endoscopic mucosal resection2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 43211 in California.

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

What 43211 covers

43211 represents flexible transoral endoscopic mucosal resection confined to the esophagus. The endoscopist identifies a superficial mucosal abnormality, separates the target tissue from the deeper wall as needed for capture, and removes it for histologic assessment. Gastroenterologists and other physicians trained in therapeutic endoscopy commonly perform this service in a hospital outpatient endoscopy unit or ambulatory surgery center. A typical indication is resection of a selected visible Barrett-associated dysplastic focus or other superficial esophageal neoplasia; this code describes mucosal resection, not sampling alone or treatment by ablation.

Report 43211 when the documented intervention is endoscopic mucosal resection of esophageal tissue, rather than biopsy alone, conventional lesion removal without mucosal resection, or ablation. Document the esophageal site, lesion findings, resection method, and any additional endoscopic work. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing governs payment. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery 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.

Where 43211 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 43211 rate is calculated

Each of 43211’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.

Payment rules and modifiers for 43211

The CMS indicators that decide how 43211 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

43211 compared with similar codes

How to choose

43216Esophageal lesion removalHot forceps or bipolar cautery

Use 43211 for endoscopic mucosal resection. Use 43216 when the documented esophageal lesion removal uses the technique represented by that code instead.

43217Esophageal lesion removalSnare technique

43211 is for mucosal resection; 43217 represents esophageal lesion removal by snare. Select according to the procedure actually performed.

43229Esophageal ablationFlexible transoral scope

43211 removes mucosal tissue for histologic assessment, while 43229 treats esophageal lesions by endoscopic ablation.

43202Esophageal biopsyFlexible transoral scope

43202 reports esophageal tissue sampling by biopsy. It does not describe therapeutic mucosal resection of the lesion.

Codes related to 43211

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

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

Open CMS sourceHow we calculate rates