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CPT code 43229: Esophageal ablation, flexible transoral scope2026 Medicare rate & RVUs in Virginia

Reports flexible transoral esophagoscopy with energy-based treatment of an esophageal lesion, such as dysplastic Barrett’s tissue, rather than lesion excision.

CMS RVU26DEffective Oct 1, 2026One payment locality1.3K Medicare services in 2024

In Virginia, Medicare pays $766.76 for 43229 in the office and $169.85 when it’s performed in a hospital or facility.

$766.76Office (non-facility)
$169.85Hospital or facility
−1.9%vs the national office rate ($781.92)

Check a contract rate as a % of Medicare · 43229 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 43229 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 43229 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 43229 covers

A gastroenterologist or other qualified endoscopist advances a flexible scope through the mouth to visualize and ablate targeted esophageal tissue. A typical setting is endoscopic treatment of Barrett’s esophagus with dysplasia; the treatment destroys the target tissue rather than removing it with forceps or a snare. The service is distinct from diagnostic inspection, biopsy, and endoscopic removal of a lesion.

Report the code when the documented service includes esophageal lesion ablation, not merely examination or tissue sampling. The procedure note should identify the treated esophageal site and lesion, the ablation performed, and the clinical indication. 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 for this descriptor and anatomy. Medicare does not pay an assistant at surgery for this service; 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 Virginia compares for 43229

Across 109 of 109 payment localities, the office rate for 43229 runs from $682.97 in Arkansas to $1,077.41 in San Benito County, CA. Virginia pays $766.76. The RVUs are the same everywhere; the geographic indexes change the dollars.

43229 in Virginia vs other payment areas
  1. Virginia · this page$766.76
  2. Los Angeles, CA · California$901.77+$135.01
  3. Washington, DC area · District of Columbia$906.12+$139.36
  4. Miami, FL · Florida$829.69+$62.93
  5. Chicago, IL · Illinois$803.72+$36.96
  6. Manhattan, NY · New York$903.26+$136.50
  7. Alaska · Alaska$875.10+$108.34

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

Every other payment area

43229 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$694.14$162.81
ArkansasArkansas$682.97$161.36
ArizonaArizona$759.65$171.24
Bakersfield, CACalifornia$841.57$176.04
Chico, CACalifornia$840.34$174.82
El Centro, CACalifornia$840.41$174.88
Fresno, CACalifornia$840.34$174.82
Hanford, CACalifornia$840.34$174.82

43229 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.

$682.97

$958.88

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

View every state and territory as a table
43229 office rate range by state
State / territoryOffice rate rangeLocalities
AK$875.101
AL$694.141
AR$682.971
AZ$759.651
CA$840.34–$1,077.4129
CO$822.181
CT$837.471
DC$906.121
DE$773.241
FL$760.00–$829.693
GA$713.84–$795.482
GU$865.841
HI$865.841
IA$718.011
ID$722.331
IL$732.67–$810.964
IN$727.091
KS$712.281
KY$708.081
LA$706.05–$745.152
MA$815.65–$912.072
MD$789.78–$906.123
ME$724.37–$770.972
MI$726.73–$768.402
MN$791.261
MO$691.22–$750.523
MS$687.341
MT$781.891
NC$733.111
ND$773.781
NE$722.991
NH$807.041
NJ$848.01–$894.752
NM$730.331
NV$780.281
NY$745.11–$924.655
OH$725.071
OK$708.811
OR$775.23–$852.892
PA$727.48–$813.442
PR$788.911
RI$804.201
SC$730.111
SD$772.821
TN$716.001
TX$722.02–$818.558
UT$741.241
VA$766.76–$906.122
VI$788.911
VT$768.601
WA$814.82–$933.692
WI$744.941
WV$702.061
WY$778.351

See 43229 in every payment locality

How the 43229 rate is calculated

Each of 43229’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 · 43229

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.40

3.40 RVUs× 1.000 GPCI

Practice expense19.60

19.60 RVUs× 1.000 GPCI

Malpractice0.41

0.41 RVUs× 1.000 GPCI

Adjusted RVUs

23.4100

Conversion factor

$33.4009

Medicare rate

$781.92

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

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,158

Code
43229
Physician work
3.40
Practice expense
19.60
Malpractice
0.41

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 43229 in Virginia
ComponentRVULocality factorAdjusted
Physician work3.40× 1.0003.4000
Practice expense19.60× 0.98319.2668
Malpractice0.41× 0.7060.2895
Total RVUs22.9563
Conversion factor× 33.4009

Office rate, Virginia$766.76

Office: (3.4 × 1 + 19.6 × 0.983 + 0.41 × 0.706) × $33.4009 = $766.76

Facility: (3.4 × 1 + 1.42 × 0.983 + 0.41 × 0.706) × $33.4009 = $169.85

Open 43229 in the RVU calculator

Payment rules and modifiers for 43229

The CMS indicators that decide how 43229 is paid alongside other services.

CMS payment indicators · 43229

Esophageal ablation, 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

43229 without 51 · national office

$781.92

Esophageal ablation, flexible transoral scope

43229-51 · Second procedure: 50%

$390.96

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 43229

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

Codes related to 43229
CodeHow it relatesOffice range, Virginia
Same family
43216Esophageal lesion removal, hot forceps or bipolar cauteryEsophageal lesion removal using forceps or cautery, rather than ablation.$445.91
43217Esophageal lesion removal, snare techniqueEsophageal lesion removal by snare; distinguish removal from ablation.$458.77
43227Esophagoscopy, endoscopic bleeding controlEsophagoscopy for control of bleeding, a different therapeutic purpose.$642.46
Used instead
43235Upper GI endoscopy, diagnostic, brushings or washingsDiagnostic upper endoscopy when no esophageal lesion ablation is performed.$316.11

How 43229 has changed in Virginia

43229 · Office / nonfacility

$766.76

Effective 2026-10-01

The base rate is $116.13 higher than on 2025-10-01, moving from $650.63 to $766.76 (17.8%).

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

    $650.63changed to$766.76

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.49 changed to 3.40
    • Practice expense RVU 16.55 changed to 19.60
    • Malpractice RVU 0.44 changed to 0.41
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $691.83changed to$650.63

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 17.23 changed to 16.55

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $680.54changed to$691.83

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $718.40changed to$680.54

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 17.53 changed to 17.23
    • Malpractice RVU 0.43 changed to 0.44
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $761.91changed to$718.40

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 18.25 changed to 17.53
    • Malpractice RVU 0.41 changed to 0.43
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $768.54changed to$761.91

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.42 changed to 0.41

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $708.66changed to$768.54

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 15.91 changed to 18.25
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $678.79changed to$708.66

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 15.13 changed to 15.91
    • Malpractice RVU 0.47 changed to 0.42
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $656.01changed to$678.79

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 14.50 changed to 15.13
    • Malpractice RVU 0.48 changed to 0.47

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $647.80changed to$656.01

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 14.36 changed to 14.50
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $720.91changed to$647.80

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 3.59 changed to 3.49
    • Practice expense RVU 16.42 changed to 14.36
    • Malpractice RVU 0.49 changed to 0.48
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $736.64changed to$720.91

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 16.75 changed to 16.42
    • Malpractice RVU 0.54 changed to 0.49

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $732.98changed to$736.64

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $722.52changed to$732.98

    • Conversion factor 35.8228 changed to 35.7547
    • Work RVU 3.54 changed to 3.59
    • Practice expense RVU 16.54 changed to 16.75
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$722.52

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$766.76$169.85RVU26D
2026-07-01$766.76$169.85RVU26C
2026-04-01$766.76$169.85RVU26B
2026-01-01$766.76$169.85RVU26A
2025-10-01$650.63$184.02RVU25D
2025-07-01$650.63$184.02RVU25C
2025-04-01$650.63$184.02RVU25B
2025-01-01$650.63$184.02RVU25A
2024-10-01$691.83$189.04RVU24D
2024-07-01$691.83$189.04RVU24C
2024-04-01$691.83$189.04RVU24B
2024-03-09$691.83$189.04RVU24AR
2024-01-01$680.54$185.96RVU24A
2023-10-01$718.40$192.37RVU23D
2023-07-01$718.40$192.37RVU23C
2023-04-01$718.40$192.37RVU23B
2023-01-01$718.40$192.37RVU23A
2022-10-01$761.91$197.20RVU22D
2022-07-01$761.91$197.20RVU22C
2022-04-01$761.91$197.20RVU22B
2022-01-01$761.91$197.20RVU22A
2021-10-01$768.54$198.46RVU21D
2021-07-01$768.54$198.46RVU21C
2021-04-01$768.54$198.46RVU21B
2021-01-01$768.54$198.46RVU21A
2020-10-01$708.66$203.66RVU20D
2020-07-01$708.66$203.66RVU20C
2020-04-01$708.66$203.66RVU20B
2020-01-01$708.66$203.66RVU20A
2019-10-01$678.79$205.47RVU19D
2019-07-01$678.79$205.47RVU19C
2019-04-01$678.79$205.47RVU19B
2019-01-01$678.79$205.47RVU19A
2018-10-01$656.01$206.29RVU18D
2018-07-01$656.01$206.29RVU18C
2018-04-01$656.01$206.29RVU18B
2018-01-01$656.01$206.29RVU18AR1
2017-10-01$647.80$204.86RVU17D
2017-07-01$647.80$204.86RVU17C
2017-04-01$647.80$204.86RVU17B
2017-01-01$647.80$204.86RVU17A
2016-10-01$720.91$208.81RVU16D
2016-07-01$720.91$208.81RVU16C
2016-04-01$720.91$208.81RVU16B
2016-01-01$720.91$208.81RVU16A
2015-10-01$736.64$213.16RVU15D
2015-07-01$736.64$213.16RVU15C
2015-04-01$732.98$212.10RVU15B
2015-01-01$732.98$212.10RVU15A
2014-10-01$722.52$209.27RVU14D
2014-07-01$722.52$209.27RVU14C
2014-04-01$722.52$209.27RVU14B
2014-01-01$722.52$209.27RVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 43229 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

43229 billing questions

How is ablation distinguished from endoscopic lesion removal?

Use this code for ablation of the esophageal target. Codes 43216 and 43217 describe lesion removal by specific techniques, including forceps or cautery and snare removal.

Can this code be reported for diagnostic esophagoscopy alone?

No. The service must include treatment by ablation; inspection or biopsy without ablation does not support this code.

Is modifier 50 appropriate for ablation on both sides of the esophagus?

No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.

How are related endoscopies priced when performed together?

CMS applies endoscopy-family pricing when related endoscopies are performed together, rather than pricing each related scope service independently.

Does Medicare pay an assistant or co-surgeon for this procedure?

An assistant at surgery is not paid for this service. Co-surgeons and team surgery 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 43229PPRRVU2026_Oct_nonQPP.csv, line 5,158 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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