CPT code 43233: Esophageal dilation, balloon 30 mm or larger2026 Medicare rate & RVUs in New Mexico
Reports upper endoscopy with balloon dilation of an esophageal narrowing using a balloon 30 mm or larger, including pneumatic dilation for achalasia.
In New Mexico, Medicare pays $204.03 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.
On this page 11 sections
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 New Mexico 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. New Mexico pays $204.03. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$204.03
- Los Angeles, CA · California$211.85+$7.82
- Washington, DC area · District of Columbia$222.62+$18.59
- Miami, FL · Florida$237.82+$33.79
- Chicago, IL · Illinois$232.08+$28.05
- Manhattan, NY · New York$232.93+$28.90
- Alaska · Alaska$264.38+$60.35
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $188.75 |
| ArkansasArkansas | — | $186.88 |
| ArizonaArizona | — | $199.52 |
| Bakersfield, CACalifornia | — | $203.38 |
| Chico, CACalifornia | — | $201.60 |
| El Centro, CACalifornia | — | $201.70 |
| Fresno, CACalifornia | — | $201.60 |
| Hanford, CACalifornia | — | $201.60 |
| Madera, CACalifornia | — | $201.60 |
| Merced, CACalifornia | — | $201.60 |
| Modesto, CACalifornia | — | $201.60 |
| Napa, CACalifornia | — | $218.39 |
| Oxnard, CACalifornia | — | $209.23 |
| Redding, CACalifornia | — | $201.60 |
| Rest of CaliforniaCalifornia | — | $201.60 |
| Riverside, CACalifornia | — | $208.30 |
| Sacramento, CACalifornia | — | $207.52 |
| Salinas, CACalifornia | — | $206.65 |
| San Diego, CACalifornia | — | $208.52 |
| Marin County, CACalifornia | — | $226.29 |
| San Francisco, CACalifornia | — | $225.58 |
| San Benito County, CACalifornia | — | $231.50 |
| Santa Clara County, CACalifornia | — | $228.62 |
| San Luis Obispo, CACalifornia | — | $203.78 |
| Santa Cruz, CACalifornia | — | $208.17 |
| Santa Maria, CACalifornia | — | $206.61 |
| Santa Rosa, CACalifornia | — | $210.02 |
| Stockton, CACalifornia | — | $201.60 |
| Vallejo, CACalifornia | — | $217.37 |
| Visalia, CACalifornia | — | $201.60 |
| Yuba City, CACalifornia | — | $201.60 |
| ColoradoColorado | — | $204.38 |
| ConnecticutConnecticut | — | $214.99 |
| DelawareDelaware | — | $202.04 |
| Fort Lauderdale, FLFlorida | — | $221.47 |
| Rest of FloridaFlorida | — | $212.26 |
| Atlanta, GAGeorgia | — | $209.45 |
| Rest of GeorgiaGeorgia | — | $202.57 |
| Hawaii, Guam, HIHawaii | — | $202.32 |
| IowaIowa | — | $187.28 |
| IdahoIdaho | — | $189.10 |
| East St. Louis, ILIllinois | — | $221.02 |
| Rest of IllinoisIllinois | — | $211.32 |
| Suburban Chicago, ILIllinois | — | $222.37 |
| IndianaIndiana | — | $189.73 |
| KansasKansas | — | $188.93 |
| KentuckyKentucky | — | $196.68 |
| New Orleans, LALouisiana | — | $203.90 |
| Rest of LouisianaLouisiana | — | $197.37 |
| Metropolitan Boston, MAMassachusetts | — | $217.09 |
| Rest of MassachusettsMassachusetts | — | $204.69 |
| Baltimore area, MDMaryland | — | $214.82 |
| Rest of MarylandMaryland | — | $204.32 |
| Rest of MaineMaine | — | $192.19 |
| Southern Maine, MEMaine | — | $195.98 |
| Detroit, MIMichigan | — | $216.51 |
| Rest of MichiganMichigan | — | $202.33 |
| MinnesotaMinnesota | — | $190.97 |
| Metropolitan Kansas City, MOMissouri | — | $200.51 |
| Metropolitan St. Louis, MOMissouri | — | $201.68 |
| Rest of MissouriMissouri | — | $196.53 |
| MississippiMississippi | — | $191.62 |
| MontanaMontana | — | $204.04 |
| North CarolinaNorth Carolina | — | $193.20 |
| North DakotaNorth Dakota | — | $191.78 |
| NebraskaNebraska | — | $187.29 |
| New HampshireNew Hampshire | — | $203.57 |
| Northern New JerseyNew Jersey | — | $221.96 |
| Rest of New JerseyNew Jersey | — | $216.06 |
| NevadaNevada | — | $200.67 |
| NYC suburbs and Long Island, NYNew York | — | $239.91 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $219.22 |
| Queens, NYNew York | — | $230.96 |
| Rest of New YorkNew York | — | $195.39 |
| OhioOhio | — | $199.83 |
| OklahomaOklahoma | — | $194.03 |
| Portland, OROregon | — | $206.54 |
| Rest of OregonOregon | — | $197.73 |
| Metropolitan Philadelphia, PAPennsylvania | — | $212.54 |
| Rest of PennsylvaniaPennsylvania | — | $198.78 |
| Puerto RicoPuerto Rico | — | $204.33 |
| Rhode IslandRhode Island | — | $206.04 |
| South CarolinaSouth Carolina | — | $197.11 |
| South DakotaSouth Dakota | — | $190.33 |
| TennesseeTennessee | — | $189.87 |
| Austin, TXTexas | — | $204.93 |
| Beaumont, TXTexas | — | $198.04 |
| Brazoria, TXTexas | — | $200.13 |
| Dallas, TXTexas | — | $202.13 |
| Fort Worth, TXTexas | — | $201.89 |
| Galveston, TXTexas | — | $201.22 |
| Houston, TXTexas | — | $212.57 |
| Rest of TexasTexas | — | $199.48 |
| UtahUtah | — | $198.92 |
| VirginiaVirginia | — | $197.13 |
| Virgin Islands, VIUnited States Virgin Islands | — | $204.33 |
| VermontVermont | — | $193.34 |
| Rest of WashingtonWashington | — | $203.54 |
| King County, WAWashington | — | $218.44 |
| WisconsinWisconsin | — | $187.62 |
| West VirginiaWest Virginia | — | $206.35 |
| WyomingWyoming | — | $198.70 |
43233 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 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.
How the rate is built · 43233
RVUs × geographic indexes × conversion factor
Work3.97
3.97 RVUs× 1.000 GPCI
Practice expense1.52
1.52 RVUs× 1.000 GPCI
Malpractice0.62
0.62 RVUs× 1.000 GPCI
Adjusted RVUs
6.1100
Conversion factor
$33.4009
Medicare rate
$204.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,162
- Code
- 43233
- Physician work
- 3.97
- Practice expense
- 1.52
- Malpractice
- 0.62
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.97 | × 1.000 | 3.9700 |
| Practice expense | 1.52 | × 0.917 | 1.3938 |
| Malpractice | 0.62 | × 1.201 | 0.7446 |
| Total RVUs | 6.1085 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$204.03
Facility: (3.97 × 1 + 1.52 × 0.917 + 0.62 × 1.201) × $33.4009 = $204.03
Payment rules and modifiers for 43233
The CMS indicators that decide how 43233 is paid alongside other services.
CMS payment indicators · 43233
Esophageal dilation, balloon 30 mm or larger
| 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) | 0 | Not 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
43233 without 51 · national facility
$204.08
Esophageal dilation, balloon 30 mm or larger
43233-51 · Second procedure: 50%
$102.04
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 43233 has changed in New Mexico
43233 · 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, 2014
RVU14A
No ratechanged toNo rate
Held through RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, 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, 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 | $204.03 | RVU26D |
| 2026-07-01 | Not available in this setting | $204.03 | RVU26C |
| 2026-04-01 | Not available in this setting | $204.03 | RVU26B |
| 2026-01-01 | Not available in this setting | $204.03 | RVU26A |
| 2025-10-01 | Not available in this setting | $217.00 | RVU25D |
| 2025-07-01 | Not available in this setting | $217.00 | RVU25C |
| 2025-04-01 | Not available in this setting | $217.00 | RVU25B |
| 2025-01-01 | Not available in this setting | $217.00 | RVU25A |
| 2024-10-01 | Not available in this setting | $222.62 | RVU24D |
| 2024-07-01 | Not available in this setting | $222.62 | RVU24C |
| 2024-04-01 | Not available in this setting | $222.62 | RVU24B |
| 2024-03-09 | Not available in this setting | $222.62 | RVU24AR |
| 2024-01-01 | Not available in this setting | $218.99 | RVU24A |
| 2023-10-01 | Not available in this setting | $223.95 | RVU23D |
| 2023-07-01 | Not available in this setting | $223.95 | RVU23C |
| 2023-04-01 | Not available in this setting | $223.95 | RVU23B |
| 2023-01-01 | Not available in this setting | $223.95 | RVU23A |
| 2022-10-01 | Not available in this setting | $228.93 | RVU22D |
| 2022-07-01 | Not available in this setting | $228.93 | RVU22C |
| 2022-04-01 | Not available in this setting | $228.93 | RVU22B |
| 2022-01-01 | Not available in this setting | $228.93 | RVU22A |
| 2021-10-01 | Not available in this setting | $229.49 | RVU21D |
| 2021-07-01 | Not available in this setting | $229.49 | RVU21C |
| 2021-04-01 | Not available in this setting | $229.49 | RVU21B |
| 2021-01-01 | Not available in this setting | $229.49 | RVU21A |
| 2020-10-01 | Not available in this setting | $236.60 | RVU20D |
| 2020-07-01 | Not available in this setting | $236.60 | RVU20C |
| 2020-04-01 | Not available in this setting | $236.60 | RVU20B |
| 2020-01-01 | Not available in this setting | $236.60 | RVU20A |
| 2019-10-01 | Not available in this setting | $240.48 | RVU19D |
| 2019-07-01 | Not available in this setting | $240.48 | RVU19C |
| 2019-04-01 | Not available in this setting | $240.48 | RVU19B |
| 2019-01-01 | Not available in this setting | $240.48 | RVU19A |
| 2018-10-01 | Not available in this setting | $240.97 | RVU18D |
| 2018-07-01 | Not available in this setting | $240.97 | RVU18C |
| 2018-04-01 | Not available in this setting | $240.97 | RVU18B |
| 2018-01-01 | Not available in this setting | $240.97 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $238.48 | RVU17D |
| 2017-07-01 | Not available in this setting | $238.48 | RVU17C |
| 2017-04-01 | Not available in this setting | $238.48 | RVU17B |
| 2017-01-01 | Not available in this setting | $238.48 | RVU17A |
| 2016-10-01 | Not available in this setting | $242.18 | RVU16D |
| 2016-07-01 | Not available in this setting | $242.18 | RVU16C |
| 2016-04-01 | Not available in this setting | $242.18 | RVU16B |
| 2016-01-01 | Not available in this setting | $242.18 | RVU16A |
| 2015-10-01 | Not available in this setting | $245.46 | RVU15D |
| 2015-07-01 | Not available in this setting | $245.46 | RVU15C |
| 2015-04-01 | Not available in this setting | $244.23 | RVU15B |
| 2015-01-01 | Not available in this setting | $244.23 | RVU15A |
| 2014-10-01 | Not available in this setting | $236.83 | RVU14D |
| 2014-07-01 | Not available in this setting | $236.83 | RVU14C |
| 2014-04-01 | Not available in this setting | $236.83 | RVU14B |
| 2014-01-01 | Not available in this setting | $236.83 | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
43233 billing questions
When should 43233 be chosen instead of 43249?
Use 43233 for esophageal balloon dilation with a balloon 30 mm or larger. Code 43249 describes esophageal balloon dilation with a balloon smaller than 30 mm.
How does 43233 differ from guidewire dilation?
43233 describes balloon dilation using a balloon at least 30 mm in diameter. Code 43248 is used for esophageal dilation over a guidewire rather than this large-balloon service.
Can the diagnostic upper endoscopy be reported separately?
Do not report a separate diagnostic EGD code just for inspection performed as part of the dilation. When related endoscopies are performed together, Medicare applies endoscopy family pricing.
Is modifier 50 appropriate for this code?
No. The anatomy and service descriptor make bilateral reporting with modifier 50 inappropriate.
What should the procedure note document?
Document the esophageal indication and treatment site, the balloon diameter used, the dilation performed, and relevant findings and response. The balloon must measure 30 mm or larger for this code.
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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