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

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 Vermont, Medicare pays $768.60 for 43229 in the office and $167.45 when it’s performed in a hospital or facility.

$768.60Office (non-facility)
$167.45Hospital or facility
−1.7%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 Vermont
  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 Vermont 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. Vermont pays $768.60. The RVUs are the same everywhere; the geographic indexes change the dollars.

43229 in Vermont vs other payment areas
  1. Vermont · this page$768.60
  2. Los Angeles, CA · California$901.77+$133.17
  3. Washington, DC area · District of Columbia$906.12+$137.52
  4. Miami, FL · Florida$829.69+$61.09
  5. Chicago, IL · Illinois$803.72+$35.12
  6. Manhattan, NY · New York$903.26+$134.66
  7. Alaska · Alaska$875.10+$106.50

Other areas in Vermont 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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 43229 in Vermont
ComponentRVULocality factorAdjusted
Physician work3.40× 1.0003.4000
Practice expense19.60× 0.99019.4040
Malpractice0.41× 0.5060.2075
Total RVUs23.0115
Conversion factor× 33.4009

Office rate, Vermont$768.60

Office: (3.4 × 1 + 19.6 × 0.99 + 0.41 × 0.506) × $33.4009 = $768.60

Facility: (3.4 × 1 + 1.42 × 0.99 + 0.41 × 0.506) × $33.4009 = $167.45

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, Vermont
Same family
43216Esophageal lesion removal, hot forceps or bipolar cauteryEsophageal lesion removal using forceps or cautery, rather than ablation.$446.91
43217Esophageal lesion removal, snare techniqueEsophageal lesion removal by snare; distinguish removal from ablation.$459.33
43227Esophagoscopy, endoscopic bleeding controlEsophagoscopy for control of bleeding, a different therapeutic purpose.$643.89
Used instead
43235Upper GI endoscopy, diagnostic, brushings or washingsDiagnostic upper endoscopy when no esophageal lesion ablation is performed.$316.23

How 43229 has changed in Vermont

43229 · Office / nonfacility

$768.60

Effective 2026-10-01

The base rate is $116.75 higher than on 2025-10-01, moving from $651.85 to $768.60 (17.9%).

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

    $651.85changed to$768.60

    • 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
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $693.29changed to$651.85

    • 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

    $681.97changed to$693.29

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $718.44changed to$681.97

    • 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
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518

  5. January 1, 2023

    RVU23A

    $761.04changed to$718.44

    • 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 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $767.55changed to$761.04

    • 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

    $713.55changed to$767.55

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 15.91 changed to 18.25
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $689.31changed to$713.55

    • 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 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $665.74changed to$689.31

    • 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

    $656.77changed to$665.74

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 14.36 changed to 14.50
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $730.76changed to$656.77

    • 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 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $746.53changed to$730.76

    • 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

    $742.81changed to$746.53

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $734.83changed to$742.81

    • 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 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$734.83

    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$768.60$167.45RVU26D
2026-07-01$768.60$167.45RVU26C
2026-04-01$768.60$167.45RVU26B
2026-01-01$768.60$167.45RVU26A
2025-10-01$651.85$180.97RVU25D
2025-07-01$651.85$180.97RVU25C
2025-04-01$651.85$180.97RVU25B
2025-01-01$651.85$180.97RVU25A
2024-10-01$693.29$185.90RVU24D
2024-07-01$693.29$185.90RVU24C
2024-04-01$693.29$185.90RVU24B
2024-03-09$693.29$185.90RVU24AR
2024-01-01$681.97$182.87RVU24A
2023-10-01$718.44$188.68RVU23D
2023-07-01$718.44$188.68RVU23C
2023-04-01$718.44$188.68RVU23B
2023-01-01$718.44$188.68RVU23A
2022-10-01$761.04$192.93RVU22D
2022-07-01$761.04$192.93RVU22C
2022-04-01$761.04$192.93RVU22B
2022-01-01$761.04$192.93RVU22A
2021-10-01$767.55$194.03RVU21D
2021-07-01$767.55$194.03RVU21C
2021-04-01$767.55$194.03RVU21B
2021-01-01$767.55$194.03RVU21A
2020-10-01$713.55$199.89RVU20D
2020-07-01$713.55$199.89RVU20C
2020-04-01$713.55$199.89RVU20B
2020-01-01$713.55$199.89RVU20A
2019-10-01$689.31$202.06RVU19D
2019-07-01$689.31$202.06RVU19C
2019-04-01$689.31$202.06RVU19B
2019-01-01$689.31$202.06RVU19A
2018-10-01$665.74$202.79RVU18D
2018-07-01$665.74$202.79RVU18C
2018-04-01$665.74$202.79RVU18B
2018-01-01$665.74$202.79RVU18AR1
2017-10-01$656.77$202.59RVU17D
2017-07-01$656.77$202.59RVU17C
2017-04-01$656.77$202.59RVU17B
2017-01-01$656.77$202.59RVU17A
2016-10-01$730.76$207.72RVU16D
2016-07-01$730.76$207.72RVU16C
2016-04-01$730.76$207.72RVU16B
2016-01-01$730.76$207.72RVU16A
2015-10-01$746.53$211.86RVU15D
2015-07-01$746.53$211.86RVU15C
2015-04-01$742.81$210.81RVU15B
2015-01-01$742.81$210.81RVU15A
2014-10-01$734.83$207.96RVU14D
2014-07-01$734.83$207.96RVU14C
2014-04-01$734.83$207.96RVU14B
2014-01-01$734.83$207.96RVU14A
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 Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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 VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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