CPT code 43231: Esophageal EUS, examination only, esophagus2026 Medicare rate & RVUs in Delaware

In Delaware, Medicare pays $137.04 for 43231 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 43231 nationwide

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

What 43231 covers

A gastroenterologist or other qualified physician passes a flexible endoscope through the mouth and uses ultrasound to examine structures in or adjacent to the esophagus. Typical uses include assessing an esophageal subepithelial lesion, wall thickening, or local tumor involvement. The ultrasound examination must be confined to the esophagus; this is not the code for an EUS-guided needle sample.

Select this service based on the documented scope and extent of the ultrasound examination, not simply the patient’s diagnosis. The report should identify the esophageal findings and support that EUS was performed. When related endoscopies are performed together, CMS endoscopy family pricing adjusts payment for the combined services. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate. CMS does not pay an assistant at surgery; co-surgeons are permitted, while team surgery is not.

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 Delaware compares for 43231

Across 109 of 109 payment localities, the facility rate for 43231 runs from $128.25 in Arkansas to $181.94 in Alaska. Delaware pays $137.04. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

43231 rates by state

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

See 43231 in every payment locality

How the 43231 rate is calculated

Each of 43231’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 43231

The CMS indicators that decide how 43231 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 43231

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

How 43231 has changed in Delaware

Price 43231 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

• Arden
• Ardencroft
• Ardentown
• Bear
• Bellefonte
• Bethany Beach
• Bethel
• Blades

Browse all communities in Delaware

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