CPT code 43233: Esophageal dilation, balloon 30 mm or larger2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $222.62 for 43233 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 43233 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 43233 covers

A gastroenterologist or other qualified physician passes an upper endoscope through the mouth to examine the esophagus and perform balloon dilation with a balloon measuring 30 mm or larger. The service may be used for an esophageal narrowing or for pneumatic dilation in achalasia. It is commonly performed in a hospital endoscopy unit or ambulatory surgery center; office use is less common.

Choose this code based on the esophageal treatment and balloon diameter, not simply because an upper endoscopy was performed. The report should identify the esophageal indication and treatment site, document balloon size and dilation, and describe the findings and response. Medicare 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. 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 Washington, DC area compares for 43233

Across 109 of 109 payment localities, the facility rate for 43233 runs from $186.88 in Arkansas to $264.38 in Alaska. Washington, DC area pays $222.62. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

43233 rates by state

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

See 43233 in every payment locality

How the 43233 rate is calculated

Each of 43233’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 43233

The CMS indicators that decide how 43233 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 43233

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

How 43233 has changed in Washington, DC area

Price 43233 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

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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