CPT code 43232: Esophageal EUS, EUS-guided needle sampling2026 Medicare rate & RVUs in Kentucky
Reports flexible esophagoscopy with ultrasound-guided needle sampling of tissue or a lesion in the esophageal wall or nearby structures.
In Kentucky, Medicare pays $170.99 for 43232 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 43232 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 43232 covers
A gastroenterologist passes a flexible endoscope through the mouth to examine the esophagus and uses endoscopic ultrasound to guide a needle into tissue for aspiration or biopsy. Typical targets include an esophageal subepithelial lesion or a mediastinal lymph node or mass accessible from the esophagus. The service is generally performed in a procedural endoscopy setting; it is distinct from sampling performed during an examination that continues into the stomach or duodenum.
Report this code when the record supports both esophagoscopy and ultrasound-guided intramural or transmural needle sampling. Document the examination extent, ultrasound findings, target, and needle sampling performed; multiple needle passes are part of the sampling service, not separate units per pass. The code 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 applies. Modifier 50 is inappropriate. CMS permits co-surgeons, does not permit team surgery, and does not pay an assistant at surgery.
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 Kentucky compares for 43232
Across 109 of 109 payment localities, the facility rate for 43232 runs from $164.35 in Arkansas to $233.04 in Alaska. Kentucky pays $170.99. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Kentucky · this page$170.99
- Los Angeles, CA · California$186.45+$15.46
- Washington, DC area · District of Columbia$193.59+$22.60
- Miami, FL · Florida$199.22+$28.23
- Chicago, IL · Illinois$195.28+$24.29
- Manhattan, NY · New York$200.16+$29.17
- Alaska · Alaska$233.04+$62.05
Other areas in Kentucky first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $165.78 |
| ArkansasArkansas | — | $164.35 |
| ArizonaArizona | — | $174.01 |
| Bakersfield, CACalifornia | — | $179.04 |
| Chico, CACalifornia | — | $177.86 |
| El Centro, CACalifornia | — | $177.92 |
| Fresno, CACalifornia | — | $177.86 |
| Hanford, CACalifornia | — | $177.86 |
| Madera, CACalifornia | — | $177.86 |
| Merced, CACalifornia | — | $177.86 |
| Modesto, CACalifornia | — | $177.86 |
| Napa, CACalifornia | — | $193.40 |
| Oxnard, CACalifornia | — | $184.35 |
| Redding, CACalifornia | — | $177.86 |
| Rest of CaliforniaCalifornia | — | $177.86 |
| Riverside, CACalifornia | — | $182.10 |
| Sacramento, CACalifornia | — | $183.25 |
| Salinas, CACalifornia | — | $182.48 |
| San Diego, CACalifornia | — | $184.20 |
| Marin County, CACalifornia | — | $200.86 |
| San Francisco, CACalifornia | — | $200.42 |
| San Benito County, CACalifornia | — | $205.14 |
| Santa Clara County, CACalifornia | — | $203.33 |
| San Luis Obispo, CACalifornia | — | $179.89 |
| Santa Cruz, CACalifornia | — | $183.97 |
| Santa Maria, CACalifornia | — | $182.46 |
| Santa Rosa, CACalifornia | — | $185.64 |
| Stockton, CACalifornia | — | $177.86 |
| Vallejo, CACalifornia | — | $192.76 |
| Visalia, CACalifornia | — | $177.86 |
| Yuba City, CACalifornia | — | $177.86 |
| ColoradoColorado | — | $178.94 |
| ConnecticutConnecticut | — | $186.08 |
| DelawareDelaware | — | $176.06 |
| Fort Lauderdale, FLFlorida | — | $188.50 |
| Rest of FloridaFlorida | — | $181.82 |
| Atlanta, GAGeorgia | — | $181.09 |
| Rest of GeorgiaGeorgia | — | $174.74 |
| Hawaii, Guam, HIHawaii | — | $178.37 |
| IowaIowa | — | $165.47 |
| IdahoIdaho | — | $166.70 |
| East St. Louis, ILIllinois | — | $186.77 |
| Rest of IllinoisIllinois | — | $180.57 |
| Suburban Chicago, ILIllinois | — | $189.51 |
| IndianaIndiana | — | $167.20 |
| KansasKansas | — | $166.34 |
| New Orleans, LALouisiana | — | $176.33 |
| Rest of LouisianaLouisiana | — | $171.36 |
| Metropolitan Boston, MAMassachusetts | — | $189.92 |
| Rest of MassachusettsMassachusetts | — | $179.10 |
| Baltimore area, MDMaryland | — | $185.78 |
| Rest of MarylandMaryland | — | $178.03 |
| Rest of MaineMaine | — | $168.64 |
| Southern Maine, MEMaine | — | $172.13 |
| Detroit, MIMichigan | — | $184.63 |
| Rest of MichiganMichigan | — | $174.91 |
| MinnesotaMinnesota | — | $169.56 |
| Metropolitan Kansas City, MOMissouri | — | $174.17 |
| Metropolitan St. Louis, MOMissouri | — | $175.11 |
| Rest of MissouriMissouri | — | $170.47 |
| MississippiMississippi | — | $167.37 |
| MontanaMontana | — | $177.33 |
| North CarolinaNorth Carolina | — | $169.48 |
| North DakotaNorth Dakota | — | $169.62 |
| NebraskaNebraska | — | $165.60 |
| New HampshireNew Hampshire | — | $177.68 |
| Northern New JerseyNew Jersey | — | $193.20 |
| Rest of New JerseyNew Jersey | — | $187.66 |
| New MexicoNew Mexico | — | $176.04 |
| NevadaNevada | — | $175.23 |
| NYC suburbs and Long Island, NYNew York | — | $204.97 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $189.86 |
| Queens, NYNew York | — | $199.23 |
| Rest of New YorkNew York | — | $171.12 |
| OhioOhio | — | $173.34 |
| OklahomaOklahoma | — | $169.38 |
| Portland, OROregon | — | $181.16 |
| Rest of OregonOregon | — | $173.30 |
| Metropolitan Philadelphia, PAPennsylvania | — | $183.92 |
| Rest of PennsylvaniaPennsylvania | — | $172.75 |
| Puerto RicoPuerto Rico | — | $177.69 |
| Rhode IslandRhode Island | — | $179.74 |
| South CarolinaSouth Carolina | — | $171.80 |
| South DakotaSouth Dakota | — | $168.71 |
| TennesseeTennessee | — | $167.01 |
| Austin, TXTexas | — | $178.86 |
| Beaumont, TXTexas | — | $172.17 |
| Brazoria, TXTexas | — | $175.00 |
| Dallas, TXTexas | — | $176.37 |
| Fort Worth, TXTexas | — | $176.07 |
| Galveston, TXTexas | — | $175.72 |
| Houston, TXTexas | — | $182.86 |
| Rest of TexasTexas | — | $173.68 |
| UtahUtah | — | $173.18 |
| VirginiaVirginia | — | $172.72 |
| Virgin Islands, VIUnited States Virgin Islands | — | $177.69 |
| VermontVermont | — | $170.45 |
| Rest of WashingtonWashington | — | $178.28 |
| King County, WAWashington | — | $191.59 |
| WisconsinWisconsin | — | $166.35 |
| West VirginiaWest Virginia | — | $176.76 |
| WyomingWyoming | — | $173.97 |
43232 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 43232 rate is calculated
Each of 43232’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 · 43232
RVUs × geographic indexes × conversion factor
Work3.50
3.50 RVUs× 1.000 GPCI
Practice expense1.42
1.42 RVUs× 1.000 GPCI
Malpractice0.39
0.39 RVUs× 1.000 GPCI
Adjusted RVUs
5.3100
Conversion factor
$33.4009
Medicare rate
$177.36
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Kentucky inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,161
- Code
- 43232
- Physician work
- 3.50
- Practice expense
- 1.42
- Malpractice
- 0.39
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.50 | × 1.000 | 3.5000 |
| Practice expense | 1.42 | × 0.889 | 1.2624 |
| Malpractice | 0.39 | × 0.915 | 0.3569 |
| Total RVUs | 5.1192 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$170.99
Facility: (3.5 × 1 + 1.42 × 0.889 + 0.39 × 0.915) × $33.4009 = $170.99
Payment rules and modifiers for 43232
The CMS indicators that decide how 43232 is paid alongside other services.
CMS payment indicators · 43232
Esophageal EUS, EUS-guided needle sampling
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
43232 without 51 · national facility
$177.36
Esophageal EUS, EUS-guided needle sampling
43232-51 · Second procedure: 50%
$88.68
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%).
How 43232 has changed in Kentucky
43232 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
January 1, 2020
RVU20A
$391.69changed toNo rate
Held through RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.
January 1, 2019
RVU19A
$380.83changed to$391.69
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 7.56 changed to 7.88
- Malpractice RVU 0.41 changed to 0.42
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$374.28changed to$380.83
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 7.42 changed to 7.56
- Malpractice RVU 0.42 changed to 0.41
- Practice expense GPCI 0.876 changed to 0.880
- Malpractice GPCI 0.807 changed to 0.819
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$440.00changed to$374.28
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 3.69 changed to 3.59
- Practice expense RVU 9.46 changed to 7.42
- Malpractice RVU 0.44 changed to 0.42
- Practice expense GPCI 0.872 changed to 0.876
- Malpractice GPCI 0.795 changed to 0.807
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$446.80changed to$440.00
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 9.59 changed to 9.46
- Malpractice RVU 0.48 changed to 0.44
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$444.58changed to$446.80
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$439.20changed to$444.58
- Conversion factor 35.8228 changed to 35.7547
- Work RVU 3.54 changed to 3.69
- Practice expense RVU 9.53 changed to 9.59
- Malpractice RVU 0.53 changed to 0.48
- Malpractice GPCI 0.774 changed to 0.795
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$439.20
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $170.99 | RVU26D |
| 2026-07-01 | Not available in this setting | $170.99 | RVU26C |
| 2026-04-01 | Not available in this setting | $170.99 | RVU26B |
| 2026-01-01 | Not available in this setting | $170.99 | RVU26A |
| 2025-10-01 | Not available in this setting | $180.97 | RVU25D |
| 2025-07-01 | Not available in this setting | $180.97 | RVU25C |
| 2025-04-01 | Not available in this setting | $180.97 | RVU25B |
| 2025-01-01 | Not available in this setting | $180.97 | RVU25A |
| 2024-10-01 | Not available in this setting | $186.55 | RVU24D |
| 2024-07-01 | Not available in this setting | $186.55 | RVU24C |
| 2024-04-01 | Not available in this setting | $186.55 | RVU24B |
| 2024-03-09 | Not available in this setting | $186.55 | RVU24AR |
| 2024-01-01 | Not available in this setting | $183.51 | RVU24A |
| 2023-10-01 | Not available in this setting | $186.70 | RVU23D |
| 2023-07-01 | Not available in this setting | $186.70 | RVU23C |
| 2023-04-01 | Not available in this setting | $186.70 | RVU23B |
| 2023-01-01 | Not available in this setting | $186.70 | RVU23A |
| 2022-10-01 | Not available in this setting | $191.03 | RVU22D |
| 2022-07-01 | Not available in this setting | $191.03 | RVU22C |
| 2022-04-01 | Not available in this setting | $191.03 | RVU22B |
| 2022-01-01 | Not available in this setting | $191.03 | RVU22A |
| 2021-10-01 | Not available in this setting | $191.43 | RVU21D |
| 2021-07-01 | Not available in this setting | $191.43 | RVU21C |
| 2021-04-01 | Not available in this setting | $191.43 | RVU21B |
| 2021-01-01 | Not available in this setting | $191.43 | RVU21A |
| 2020-10-01 | Not available in this setting | $197.05 | RVU20D |
| 2020-07-01 | Not available in this setting | $197.05 | RVU20C |
| 2020-04-01 | Not available in this setting | $197.05 | RVU20B |
| 2020-01-01 | Not available in this setting | $197.05 | RVU20A |
| 2019-10-01 | $391.69 | $199.18 | RVU19D |
| 2019-07-01 | $391.69 | $199.18 | RVU19C |
| 2019-04-01 | $391.69 | $199.18 | RVU19B |
| 2019-01-01 | $391.69 | $199.18 | RVU19A |
| 2018-10-01 | $380.83 | $199.30 | RVU18D |
| 2018-07-01 | $380.83 | $199.30 | RVU18C |
| 2018-04-01 | $380.83 | $199.30 | RVU18B |
| 2018-01-01 | $380.83 | $199.30 | RVU18AR1 |
| 2017-10-01 | $374.28 | $197.59 | RVU17D |
| 2017-07-01 | $374.28 | $197.59 | RVU17C |
| 2017-04-01 | $374.28 | $197.59 | RVU17B |
| 2017-01-01 | $374.28 | $197.59 | RVU17A |
| 2016-10-01 | $440.00 | $202.09 | RVU16D |
| 2016-07-01 | $440.00 | $202.09 | RVU16C |
| 2016-04-01 | $440.00 | $202.09 | RVU16B |
| 2016-01-01 | $440.00 | $202.09 | RVU16A |
| 2015-10-01 | $446.80 | $205.21 | RVU15D |
| 2015-07-01 | $446.80 | $205.21 | RVU15C |
| 2015-04-01 | $444.58 | $204.19 | RVU15B |
| 2015-01-01 | $444.58 | $204.19 | RVU15A |
| 2014-10-01 | $439.20 | $199.30 | RVU14D |
| 2014-07-01 | $439.20 | $199.30 | RVU14C |
| 2014-04-01 | $439.20 | $199.30 | RVU14B |
| 2014-01-01 | $439.20 | $199.30 | RVU14A |
| 2013-10-01 | Not available in this setting | $246.79 | RVU13D |
| 2013-07-01 | Not available in this setting | $246.79 | RVU13C |
| 2013-04-01 | Not available in this setting | $246.79 | RVU13B |
| 2013-01-01 | Not available in this setting | $246.79 | RVU13AR |
Where the Kentucky rate applies
Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.
- Adairville
- Ages
- Albany
- Alexandria
- Allen
- Allensville
- Anchorage
- Annville
43232 billing questions
When should this be chosen instead of 43231?
Use 43232 when ultrasound-guided needle aspiration or biopsy is performed. 43231 describes esophagoscopy with ultrasound examination without needle sampling.
How does this differ from an EGD with EUS-guided sampling?
43232 describes an esophagoscopy service focused on the esophagus and targets accessible from it. When the endoscopic examination and sampling are performed through an EGD route, consider the applicable EGD sampling code, such as 43238.
Are multiple needle passes reported as separate units?
No. The needle sampling is reported as the procedure, not as a separate unit for each pass. Document the target and sampling performed.
Can modifier 50 be used for bilateral sampling?
No. CMS identifies bilateral adjustment as inappropriate for this code, even when targets are sampled on both sides.
How does CMS handle related endoscopies performed together?
CMS endoscopy family pricing applies when related endoscopies are performed together. The code also has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant or another surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons are permitted, while team surgery is 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
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