CPT code 43237: Endoscopic ultrasound, limited upper GI examination2026 Medicare rate & RVUs in Minnesota
Upper gastrointestinal endoscopic ultrasound evaluates the esophageal, gastric, or duodenal wall and nearby structures when imaging beyond standard endoscopy is needed.
In Minnesota, Medicare pays $165.46 for 43237 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 43237 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 43237 covers
A gastroenterologist advances an endoscope with an ultrasound probe to assess the wall of the esophagus, stomach, or duodenum and adjacent structures. Common reasons include evaluating a subepithelial lesion, assessing wall layers, or examining nearby lymph nodes or pancreaticobiliary structures that are within the scope of the study. The service is performed in an endoscopy unit, ambulatory surgery center, or hospital facility.
Report this code when the EUS examination is limited to the specified upper gastrointestinal region and no EUS-guided needle aspiration or biopsy is performed. Document the indication, anatomic extent, structures examined, findings, and any sampling performed; needle sampling changes the code selection. 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, and CMS does not pay an assistant at surgery, co-surgeons, or a team of surgeons for this service.
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 Minnesota compares for 43237
Across 109 of 109 payment localities, the facility rate for 43237 runs from $160.17 in Arkansas to $226.85 in Alaska. Minnesota pays $165.46. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Minnesota · this page$165.46
- Los Angeles, CA · California$182.06+$16.60
- Washington, DC area · District of Columbia$188.99+$23.53
- Miami, FL · Florida$194.37+$28.91
- Chicago, IL · Illinois$190.48+$25.02
- Manhattan, NY · New York$195.36+$29.90
- Alaska · Alaska$226.85+$61.39
Other areas in Minnesota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $161.58 |
| ArkansasArkansas | — | $160.17 |
| ArizonaArizona | — | $169.72 |
| Bakersfield, CACalifornia | — | $174.75 |
| Chico, CACalifornia | — | $173.60 |
| El Centro, CACalifornia | — | $173.66 |
| Fresno, CACalifornia | — | $173.60 |
| Hanford, CACalifornia | — | $173.60 |
| Madera, CACalifornia | — | $173.60 |
| Merced, CACalifornia | — | $173.60 |
| Modesto, CACalifornia | — | $173.60 |
| Napa, CACalifornia | — | $188.97 |
| Oxnard, CACalifornia | — | $180.02 |
| Redding, CACalifornia | — | $173.60 |
| Rest of CaliforniaCalifornia | — | $173.60 |
| Riverside, CACalifornia | — | $177.74 |
| Sacramento, CACalifornia | — | $178.92 |
| Salinas, CACalifornia | — | $178.17 |
| San Diego, CACalifornia | — | $179.89 |
| Marin County, CACalifornia | — | $196.32 |
| San Francisco, CACalifornia | — | $195.89 |
| San Benito County, CACalifornia | — | $200.51 |
| Santa Clara County, CACalifornia | — | $198.75 |
| San Luis Obispo, CACalifornia | — | $175.64 |
| Santa Cruz, CACalifornia | — | $179.70 |
| Santa Maria, CACalifornia | — | $178.16 |
| Santa Rosa, CACalifornia | — | $181.33 |
| Stockton, CACalifornia | — | $173.60 |
| Vallejo, CACalifornia | — | $188.35 |
| Visalia, CACalifornia | — | $173.60 |
| Yuba City, CACalifornia | — | $173.60 |
| ColoradoColorado | — | $174.63 |
| ConnecticutConnecticut | — | $181.59 |
| DelawareDelaware | — | $171.73 |
| Fort Lauderdale, FLFlorida | — | $183.89 |
| Rest of FloridaFlorida | — | $177.31 |
| Atlanta, GAGeorgia | — | $176.67 |
| Rest of GeorgiaGeorgia | — | $170.33 |
| Hawaii, Guam, HIHawaii | — | $174.17 |
| IowaIowa | — | $161.33 |
| IdahoIdaho | — | $162.53 |
| East St. Louis, ILIllinois | — | $182.09 |
| Rest of IllinoisIllinois | — | $176.04 |
| Suburban Chicago, ILIllinois | — | $184.89 |
| IndianaIndiana | — | $163.03 |
| KansasKansas | — | $162.17 |
| KentuckyKentucky | — | $166.67 |
| New Orleans, LALouisiana | — | $171.94 |
| Rest of LouisianaLouisiana | — | $167.03 |
| Metropolitan Boston, MAMassachusetts | — | $185.45 |
| Rest of MassachusettsMassachusetts | — | $174.76 |
| Baltimore area, MDMaryland | — | $181.29 |
| Rest of MarylandMaryland | — | $173.67 |
| Rest of MaineMaine | — | $164.42 |
| Southern Maine, MEMaine | — | $167.91 |
| Detroit, MIMichigan | — | $180.06 |
| Rest of MichiganMichigan | — | $170.53 |
| Metropolitan Kansas City, MOMissouri | — | $169.83 |
| Metropolitan St. Louis, MOMissouri | — | $170.77 |
| Rest of MissouriMissouri | — | $166.14 |
| MississippiMississippi | — | $163.11 |
| MontanaMontana | — | $172.99 |
| North CarolinaNorth Carolina | — | $165.26 |
| North DakotaNorth Dakota | — | $165.48 |
| NebraskaNebraska | — | $161.47 |
| New HampshireNew Hampshire | — | $173.37 |
| Northern New JerseyNew Jersey | — | $188.58 |
| Rest of New JerseyNew Jersey | — | $183.13 |
| New MexicoNew Mexico | — | $171.63 |
| NevadaNevada | — | $170.94 |
| NYC suburbs and Long Island, NYNew York | — | $200.08 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $185.27 |
| Queens, NYNew York | — | $194.48 |
| Rest of New YorkNew York | — | $166.88 |
| OhioOhio | — | $168.99 |
| OklahomaOklahoma | — | $165.11 |
| Portland, OROregon | — | $176.84 |
| Rest of OregonOregon | — | $169.06 |
| Metropolitan Philadelphia, PAPennsylvania | — | $179.44 |
| Rest of PennsylvaniaPennsylvania | — | $168.43 |
| Puerto RicoPuerto Rico | — | $173.35 |
| Rhode IslandRhode Island | — | $175.36 |
| South CarolinaSouth Carolina | — | $167.51 |
| South DakotaSouth Dakota | — | $164.59 |
| TennesseeTennessee | — | $162.82 |
| Austin, TXTexas | — | $174.55 |
| Beaumont, TXTexas | — | $167.85 |
| Brazoria, TXTexas | — | $170.70 |
| Dallas, TXTexas | — | $172.04 |
| Fort Worth, TXTexas | — | $171.73 |
| Galveston, TXTexas | — | $171.40 |
| Houston, TXTexas | — | $178.36 |
| Rest of TexasTexas | — | $169.37 |
| UtahUtah | — | $168.88 |
| VirginiaVirginia | — | $168.48 |
| Virgin Islands, VIUnited States Virgin Islands | — | $173.35 |
| VermontVermont | — | $166.27 |
| Rest of WashingtonWashington | — | $173.96 |
| King County, WAWashington | — | $187.11 |
| WisconsinWisconsin | — | $162.24 |
| West VirginiaWest Virginia | — | $172.27 |
| WyomingWyoming | — | $169.72 |
43237 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 43237 rate is calculated
Each of 43237’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 · 43237
RVUs × geographic indexes × conversion factor
Work3.38
3.38 RVUs× 1.000 GPCI
Practice expense1.42
1.42 RVUs× 1.000 GPCI
Malpractice0.38
0.38 RVUs× 1.000 GPCI
Adjusted RVUs
5.1800
Conversion factor
$33.4009
Medicare rate
$173.02
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Minnesota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,165
- Code
- 43237
- Physician work
- 3.38
- Practice expense
- 1.42
- Malpractice
- 0.38
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.38 | × 1.000 | 3.3800 |
| Practice expense | 1.42 | × 1.029 | 1.4612 |
| Malpractice | 0.38 | × 0.296 | 0.1125 |
| Total RVUs | 4.9537 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Minnesota$165.46
Facility: (3.38 × 1 + 1.42 × 1.029 + 0.38 × 0.296) × $33.4009 = $165.46
Payment rules and modifiers for 43237
The CMS indicators that decide how 43237 is paid alongside other services.
CMS payment indicators · 43237
Endoscopic ultrasound, limited upper GI examination
| 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
43237 without 51 · national facility
$173.02
Endoscopic ultrasound, limited upper GI examination
43237-51 · Second procedure: 50%
$86.51
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 43237 has changed in Minnesota
43237 · 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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $165.46 | RVU26D |
| 2026-07-01 | Not available in this setting | $165.46 | RVU26C |
| 2026-04-01 | Not available in this setting | $165.46 | RVU26B |
| 2026-01-01 | Not available in this setting | $165.46 | RVU26A |
| 2025-10-01 | Not available in this setting | $179.45 | RVU25D |
| 2025-07-01 | Not available in this setting | $179.45 | RVU25C |
| 2025-04-01 | Not available in this setting | $179.45 | RVU25B |
| 2025-01-01 | Not available in this setting | $179.45 | RVU25A |
| 2024-10-01 | Not available in this setting | $184.33 | RVU24D |
| 2024-07-01 | Not available in this setting | $184.33 | RVU24C |
| 2024-04-01 | Not available in this setting | $184.33 | RVU24B |
| 2024-03-09 | Not available in this setting | $184.33 | RVU24AR |
| 2024-01-01 | Not available in this setting | $181.32 | RVU24A |
| 2023-10-01 | Not available in this setting | $186.58 | RVU23D |
| 2023-07-01 | Not available in this setting | $186.58 | RVU23C |
| 2023-04-01 | Not available in this setting | $186.58 | RVU23B |
| 2023-01-01 | Not available in this setting | $186.58 | RVU23A |
| 2022-10-01 | Not available in this setting | $190.40 | RVU22D |
| 2022-07-01 | Not available in this setting | $190.40 | RVU22C |
| 2022-04-01 | Not available in this setting | $190.40 | RVU22B |
| 2022-01-01 | Not available in this setting | $190.40 | RVU22A |
| 2021-10-01 | Not available in this setting | $191.03 | RVU21D |
| 2021-07-01 | Not available in this setting | $191.03 | RVU21C |
| 2021-04-01 | Not available in this setting | $191.03 | RVU21B |
| 2021-01-01 | Not available in this setting | $191.03 | RVU21A |
| 2020-10-01 | Not available in this setting | $195.74 | RVU20D |
| 2020-07-01 | Not available in this setting | $195.74 | RVU20C |
| 2020-04-01 | Not available in this setting | $195.74 | RVU20B |
| 2020-01-01 | Not available in this setting | $195.74 | RVU20A |
| 2019-10-01 | Not available in this setting | $197.11 | RVU19D |
| 2019-07-01 | Not available in this setting | $197.11 | RVU19C |
| 2019-04-01 | Not available in this setting | $197.11 | RVU19B |
| 2019-01-01 | Not available in this setting | $197.11 | RVU19A |
| 2018-10-01 | Not available in this setting | $198.11 | RVU18D |
| 2018-07-01 | Not available in this setting | $198.11 | RVU18C |
| 2018-04-01 | Not available in this setting | $198.11 | RVU18B |
| 2018-01-01 | Not available in this setting | $198.11 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $197.01 | RVU17D |
| 2017-07-01 | Not available in this setting | $197.01 | RVU17C |
| 2017-04-01 | Not available in this setting | $197.01 | RVU17B |
| 2017-01-01 | Not available in this setting | $197.01 | RVU17A |
| 2016-10-01 | Not available in this setting | $201.37 | RVU16D |
| 2016-07-01 | Not available in this setting | $201.37 | RVU16C |
| 2016-04-01 | Not available in this setting | $201.37 | RVU16B |
| 2016-01-01 | Not available in this setting | $201.37 | RVU16A |
| 2015-10-01 | Not available in this setting | $204.50 | RVU15D |
| 2015-07-01 | Not available in this setting | $204.50 | RVU15C |
| 2015-04-01 | Not available in this setting | $203.48 | RVU15B |
| 2015-01-01 | Not available in this setting | $203.48 | RVU15A |
| 2014-10-01 | Not available in this setting | $203.37 | RVU14D |
| 2014-07-01 | Not available in this setting | $203.37 | RVU14C |
| 2014-04-01 | Not available in this setting | $203.37 | RVU14B |
| 2014-01-01 | Not available in this setting | $203.37 | RVU14A |
| 2013-10-01 | Not available in this setting | $223.46 | RVU13D |
| 2013-07-01 | Not available in this setting | Rate data unavailable | RVU13C |
| 2013-04-01 | Not available in this setting | Rate data unavailable | RVU13B |
| 2013-01-01 | Not available in this setting | Rate data unavailable | RVU13AR |
Where the Minnesota rate applies
Minnesota is a Medicare payment area, not a city. Our Census mapping connects it to 916 cities and communities in Minnesota. Some span more than one payment area; confirm with the service ZIP.
- Ada
- Adams
- Adrian
- Afton
- Aitkin
- Akeley
- Albany
- Albert Lea
43237 billing questions
When should 43237 be used instead of 43238?
Use 43237 for the limited EUS examination without EUS-guided needle aspiration or biopsy. When needle sampling is performed, use the applicable sampling code, such as 43238.
Can the diagnostic EGD be billed separately with 43237?
The endoscopic access and examination needed to perform the EUS are part of the service. Do not separately report a diagnostic EGD for that same examination.
How does 43237 differ from 43259?
43237 describes an examination limited to the esophagus, stomach, or duodenum and adjacent structures. Use 43259 when the examination includes the broader anatomic extent specified for that code.
Should modifier 50 be appended for bilateral findings?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
What documentation supports reporting 43237?
Document why EUS was needed, the anatomic region examined, the structures assessed, and the findings. State whether needle aspiration or biopsy occurred, since that affects code selection.
Are assistant surgeon or co-surgeon services payable with 43237?
CMS does not pay an assistant at surgery for this service and does not permit co-surgeons or team surgery.
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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