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CPT code 43217: Esophageal lesion removal, snare technique2026 Medicare rate & RVUs in Puerto Rico

Flexible transoral esophagoscopy with snare excision is reported when a gastroenterologist removes an esophageal polyp, tumor, or other lesion using a snare.

CMS RVU26DEffective Oct 1, 2026One payment locality32 Medicare services in 2024

In Puerto Rico, Medicare pays $471.83 for 43217 in the office and $142.59 when it’s performed in a hospital or facility.

$471.83Office (non-facility)
$142.59Hospital or facility
+0.8%vs the national office rate ($467.95)

Check a contract rate as a % of Medicare · 43217 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 43217 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 43217 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 43217 covers

A gastroenterologist advances a flexible endoscope through the mouth to examine the esophagus, then uses a snare loop to capture and remove a polyp, tumor, or other lesion. The service is performed in an endoscopy suite, hospital outpatient department, or ambulatory surgery center. The defining feature is snare removal of an esophageal lesion, rather than sampling it with biopsy forceps or treating it with another technique.

Report the code when the procedure record identifies the esophageal lesion and documents removal with a snare. The minor-procedure global period is 0 days, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for it, and 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.

How Puerto Rico compares for 43217

Across 109 of 109 payment localities, the office rate for 43217 runs from $411.38 in Arkansas to $635.43 in San Benito County, CA. Puerto Rico pays $471.83. The RVUs are the same everywhere; the geographic indexes change the dollars.

43217 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$471.83
  2. Los Angeles, CA · California$535.43+$63.60
  3. Washington, DC area · District of Columbia$539.28+$67.45
  4. Miami, FL · Florida$498.30+$26.47
  5. Chicago, IL · Illinois$483.39+$11.56
  6. Manhattan, NY · New York$539.07+$67.24
  7. Alaska · Alaska$532.88+$61.05

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

Every other payment area

43217 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$417.76$132.80
ArkansasArkansas$411.38$131.64
ArizonaArizona$455.13$139.57
Bakersfield, CACalifornia$500.97$144.05
Chico, CACalifornia$500.05$143.13
El Centro, CACalifornia$500.10$143.18
Fresno, CACalifornia$500.05$143.13
Hanford, CACalifornia$500.05$143.13

43217 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.

$411.38

$567.74

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

View every state and territory as a table
43217 office rate range by state
State / territoryOffice rate rangeLocalities
AK$532.881
AL$417.761
AR$411.381
AZ$455.131
CA$500.05–$635.4329
CO$490.321
CT$500.111
DC$539.281
DE$462.991
FL$456.85–$498.303
GA$430.26–$476.102
GU$513.971
HI$513.971
IA$430.731
ID$433.331
IL$441.68–$486.224
IN$436.021
KS$427.771
KY$426.391
LA$425.35–$447.672
MA$486.81–$541.732
MD$472.44–$539.283
ME$434.82–$460.952
MI$437.33–$461.982
MN$471.531
MO$417.08–$450.363
MS$414.351
MT$467.931
NC$439.761
ND$461.991
NE$433.471
NH$481.731
NJ$506.31–$533.052
NM$439.521
NV$466.641
NY$446.63–$551.685
OH$436.121
OK$426.471
OR$463.50–$507.552
PA$437.32–$486.562
PR$471.831
RI$480.701
SC$438.571
SD$461.291
TN$429.931
TX$434.23–$488.268
UT$444.921
VA$458.77–$539.282
VI$471.831
VT$459.331
WA$486.17–$553.922
WI$445.611
WV$424.221
WY$465.341

See 43217 in every payment locality

How the 43217 rate is calculated

Each of 43217’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 · 43217

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.73

2.73 RVUs× 1.000 GPCI

Practice expense10.98

10.98 RVUs× 1.000 GPCI

Malpractice0.30

0.30 RVUs× 1.000 GPCI

Adjusted RVUs

14.0100

Conversion factor

$33.4009

Medicare rate

$467.95

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,154

Code
43217
Physician work
2.73
Practice expense
10.98
Malpractice
0.30

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 43217 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.73× 1.0002.7300
Practice expense10.98× 1.01111.1008
Malpractice0.30× 0.9850.2955
Total RVUs14.1263
Conversion factor× 33.4009

Office rate, Puerto Rico$471.83

Office: (2.73 × 1 + 10.98 × 1.011 + 0.3 × 0.985) × $33.4009 = $471.83

Facility: (2.73 × 1 + 1.23 × 1.011 + 0.3 × 0.985) × $33.4009 = $142.59

Open 43217 in the RVU calculator

Payment rules and modifiers for 43217

The CMS indicators that decide how 43217 is paid alongside other services.

CMS payment indicators · 43217

Esophageal lesion removal, snare technique

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

43217 without 51 · national office

$467.95

Esophageal lesion removal, snare technique

43217-51 · Second procedure: 50%

$233.98

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 43217

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

Codes related to 43217
CodeHow it relatesOffice range, Puerto Rico
Used instead
43216Esophageal lesion removal, hot forceps or bipolar cauteryEsophageal lesion removal by hot biopsy forceps or bipolar cautery rather than snare.$458.56
43211Esophageal resection, endoscopic mucosal resectionEsophageal lesion removal by endoscopic mucosal resection.No office rate
43251EGD lesion removal, snare techniqueSnare removal when the service is an upper gastrointestinal endoscopy rather than esophagoscopy.$550.19
43202Esophageal biopsy, flexible transoral scopeEsophageal tissue sampling by biopsy, rather than snare removal of a lesion.$396.65
43229Esophageal ablation, flexible transoral scopeEsophageal lesion treatment by ablation rather than snare excision.$788.91

How 43217 has changed in Puerto Rico

43217 · Office / nonfacility

$471.83

Effective 2026-10-01

The base rate is $70.79 higher than on 2025-10-01, moving from $401.04 to $471.83 (17.7%).

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

    $401.04changed to$471.83

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.80 changed to 2.73
    • Practice expense RVU 9.20 changed to 10.98
    • Malpractice RVU 0.34 changed to 0.30
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $421.10changed to$401.04

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.46 changed to 9.20
    • Malpractice RVU 0.33 changed to 0.34

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $414.22changed to$421.10

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $431.09changed to$414.22

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.54 changed to 9.46
    • Malpractice RVU 0.31 changed to 0.33
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $428.67changed to$431.09

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $451.07changed to$428.67

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.85 changed to 9.54
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $449.90changed to$451.07

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.72 changed to 9.85
    • Malpractice RVU 0.30 changed to 0.31

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $414.78changed to$449.90

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.33 changed to 9.72
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $403.69changed to$414.78

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.94 changed to 8.33
    • Malpractice RVU 0.41 changed to 0.30
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $391.27changed to$403.69

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.59 changed to 7.94
    • Malpractice RVU 0.43 changed to 0.41

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $342.72changed to$391.27

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.57 changed to 7.59
    • Malpractice RVU 0.42 changed to 0.43
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $344.71changed to$342.72

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 2.90 changed to 2.80
    • Practice expense RVU 9.36 changed to 7.57
    • Malpractice RVU 0.44 changed to 0.42
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $348.66changed to$344.71

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.45 changed to 9.36
    • Malpractice RVU 0.48 changed to 0.44

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $346.92changed to$348.66

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $340.48changed to$346.92

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.36 changed to 9.45
    • Malpractice RVU 0.47 changed to 0.48
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $297.05changed to$340.48

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.42 changed to 9.36
    • Malpractice RVU 0.49 changed to 0.47
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $297.05

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$471.83$142.59RVU26D
2026-07-01$471.83$142.59RVU26C
2026-04-01$471.83$142.59RVU26B
2026-01-01$471.83$142.59RVU26A
2025-10-01$401.04$153.81RVU25D
2025-07-01$401.04$153.81RVU25C
2025-04-01$401.04$153.81RVU25B
2025-01-01$401.04$153.81RVU25A
2024-10-01$421.10$157.62RVU24D
2024-07-01$421.10$157.62RVU24C
2024-04-01$421.10$157.62RVU24B
2024-03-09$421.10$157.62RVU24AR
2024-01-01$414.22$155.05RVU24A
2023-10-01$431.09$158.85RVU23D
2023-07-01$428.67$158.59RVU23C
2023-04-01$428.67$158.59RVU23B
2023-01-01$428.67$158.59RVU23A
2022-10-01$451.07$162.24RVU22D
2022-07-01$451.07$162.24RVU22C
2022-04-01$451.07$162.24RVU22B
2022-01-01$451.07$162.24RVU22A
2021-10-01$449.90$162.89RVU21D
2021-07-01$449.90$162.89RVU21C
2021-04-01$449.90$162.89RVU21B
2021-01-01$449.90$162.89RVU21A
2020-10-01$414.78$167.04RVU20D
2020-07-01$414.78$167.04RVU20C
2020-04-01$414.78$167.04RVU20B
2020-01-01$414.78$167.04RVU20A
2019-10-01$403.69$169.25RVU19D
2019-07-01$403.69$169.25RVU19C
2019-04-01$403.69$169.25RVU19B
2019-01-01$403.69$169.25RVU19A
2018-10-01$391.27$170.14RVU18D
2018-07-01$391.27$170.14RVU18C
2018-04-01$391.27$170.14RVU18B
2018-01-01$391.27$170.14RVU18AR1
2017-10-01$342.72$156.25RVU17D
2017-07-01$342.72$156.25RVU17C
2017-04-01$342.72$156.25RVU17B
2017-01-01$342.72$156.25RVU17A
2016-10-01$344.71$147.07RVU16D
2016-07-01$344.71$147.07RVU16C
2016-04-01$344.71$147.07RVU16B
2016-01-01$344.71$147.07RVU16A
2015-10-01$348.66$148.78RVU15D
2015-07-01$348.66$148.78RVU15C
2015-04-01$346.92$148.04RVU15B
2015-01-01$346.92$148.04RVU15A
2014-10-01$340.48$148.11RVU14D
2014-07-01$340.48$148.11RVU14C
2014-04-01$340.48$148.11RVU14B
2014-01-01$340.48$148.11RVU14A
2013-10-01$297.05$143.65RVU13D
2013-07-01$297.05$143.65RVU13C
2013-04-01$297.05$143.65RVU13B
2013-01-01$297.05$143.65RVU13AR

Price 43217 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

43217 billing questions

How is this different from 43216?

This code is for snare removal. Code 43216 describes lesion removal using hot biopsy forceps or bipolar cautery.

When should 43211 be considered instead?

Use 43211 when the esophageal lesion is removed by endoscopic mucosal resection. The documented removal technique distinguishes it from snare excision under this code.

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this service.

What happens if related endoscopies are performed in the same session?

CMS endoscopy-family pricing applies when related endoscopies are performed together. The procedure record should support each service reported.

Does this code include same-day postoperative care?

Yes. It has a 0-day global period, which includes same-day preoperative and postoperative care.

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 43217PPRRVU2026_Oct_nonQPP.csv, line 5,154 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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