CPT code 43239: EGD with biopsy, single or multiple biopsies2026 Medicare rate & RVUs in North Dakota
Report one EGD with biopsy when tissue is sampled from the esophagus, stomach, or duodenum, regardless of the number of biopsy sites.
In North Dakota, Medicare pays $413.49 for 43239 in the office and $118.23 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 43239 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 43239 covers
The endoscopist passes a flexible scope through the mouth to examine the upper digestive tract and takes tissue samples with biopsy forceps. Common reasons include gastric sampling for Helicobacter pylori, duodenal sampling for suspected celiac disease, esophageal sampling for eosinophilic esophagitis, and Barrett's esophagus surveillance. Gastroenterologists and some surgeons perform the procedure, primarily in hospital outpatient departments and ambulatory surgery centers, but also in offices.
Report one unit for the EGD session regardless of the number of biopsies or sites sampled. The procedure note should identify the sampled sites and endoscopic findings; a pathologist's tissue examination is billed separately. CMS assigns a 0-day global period, which includes same-day preprocedure and postprocedure care. When another procedure in the same endoscopy family is separately reportable, endoscopy family pricing pays the highest-valued procedure in full and reduces the other procedure's payment by the diagnostic base endoscopy value. Modifier 50 is inappropriate for this procedure. An assistant surgeon is not paid, and co-surgeon or team-surgery billing is 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 North Dakota compares for 43239
Across 109 of 109 payment localities, the office rate for 43239 runs from $367.66 in Arkansas to $569.97 in San Benito County, CA. North Dakota pays $413.49. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Dakota · this page$413.49
- Los Angeles, CA · California$479.76+$66.27
- Washington, DC area · District of Columbia$483.17+$69.68
- Miami, FL · Florida$446.25+$32.76
- Chicago, IL · Illinois$432.73+$19.24
- Manhattan, NY · New York$482.90+$69.41
- Alaska · Alaska$475.29+$61.80
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $373.43 | $115.08 |
| ArkansasArkansas | $367.66 | $114.03 |
| ArizonaArizona | $407.26 | $121.15 |
| Bakersfield, CACalifornia | $448.67 | $125.06 |
| Chico, CACalifornia | $447.86 | $124.25 |
| El Centro, CACalifornia | $447.90 | $124.29 |
| Fresno, CACalifornia | $447.86 | $124.25 |
| Hanford, CACalifornia | $447.86 | $124.25 |
| Madera, CACalifornia | $447.86 | $124.25 |
| Merced, CACalifornia | $447.86 | $124.25 |
| Modesto, CACalifornia | $447.86 | $124.25 |
| Napa, CACalifornia | $524.89 | $135.73 |
| Oxnard, CACalifornia | $478.05 | $129.05 |
| Redding, CACalifornia | $447.86 | $124.25 |
| Rest of CaliforniaCalifornia | $447.86 | $124.25 |
| Riverside, CACalifornia | $450.79 | $127.19 |
| Sacramento, CACalifornia | $471.58 | $128.19 |
| Salinas, CACalifornia | $469.86 | $127.65 |
| San Diego, CACalifornia | $482.12 | $128.99 |
| Marin County, CACalifornia | $557.48 | $141.16 |
| San Francisco, CACalifornia | $557.18 | $140.85 |
| San Benito County, CACalifornia | $569.97 | $144.20 |
| Santa Clara County, CACalifornia | $568.72 | $142.95 |
| San Luis Obispo, CACalifornia | $462.13 | $125.83 |
| Santa Cruz, CACalifornia | $487.68 | $128.93 |
| Santa Maria, CACalifornia | $471.95 | $127.68 |
| Santa Rosa, CACalifornia | $492.69 | $130.11 |
| Stockton, CACalifornia | $447.86 | $124.25 |
| Vallejo, CACalifornia | $524.45 | $135.29 |
| Visalia, CACalifornia | $447.86 | $124.25 |
| Yuba City, CACalifornia | $447.86 | $124.25 |
| ColoradoColorado | $439.05 | $124.89 |
| ConnecticutConnecticut | $447.86 | $129.86 |
| DelawareDelaware | $414.34 | $122.62 |
| Fort Lauderdale, FLFlorida | $430.45 | $131.35 |
| Rest of FloridaFlorida | $408.78 | $126.50 |
| Atlanta, GAGeorgia | $426.21 | $126.22 |
| Rest of GeorgiaGeorgia | $384.72 | $121.35 |
| Hawaii, Guam, HIHawaii | $460.54 | $124.82 |
| IowaIowa | $385.19 | $115.02 |
| IdahoIdaho | $387.53 | $115.89 |
| East St. Louis, ILIllinois | $401.43 | $129.79 |
| Rest of IllinoisIllinois | $395.04 | $125.46 |
| Suburban Chicago, ILIllinois | $435.32 | $132.08 |
| IndianaIndiana | $389.98 | $116.27 |
| KansasKansas | $382.50 | $115.58 |
| KentuckyKentucky | $381.23 | $118.74 |
| New Orleans, LALouisiana | $400.49 | $122.64 |
| Rest of LouisianaLouisiana | $380.29 | $118.98 |
| Metropolitan Boston, MAMassachusetts | $485.46 | $132.91 |
| Rest of MassachusettsMassachusetts | $435.86 | $124.95 |
| Baltimore area, MDMaryland | $446.47 | $129.65 |
| Rest of MarylandMaryland | $422.87 | $124.06 |
| Rest of MaineMaine | $388.88 | $117.24 |
| Southern Maine, MEMaine | $412.53 | $119.92 |
| Detroit, MIMichigan | $413.41 | $128.48 |
| Rest of MichiganMichigan | $391.13 | $121.55 |
| MinnesotaMinnesota | $422.13 | $118.30 |
| Metropolitan Kansas City, MOMissouri | $398.39 | $121.13 |
| Metropolitan St. Louis, MOMissouri | $402.93 | $121.84 |
| Rest of MissouriMissouri | $372.80 | $118.28 |
| MississippiMississippi | $370.34 | $116.12 |
| MontanaMontana | $418.83 | $123.57 |
| North CarolinaNorth Carolina | $393.35 | $117.87 |
| NebraskaNebraska | $387.67 | $115.14 |
| New HampshireNew Hampshire | $431.33 | $123.96 |
| Northern New JerseyNew Jersey | $477.48 | $134.98 |
| Rest of New JerseyNew Jersey | $453.38 | $130.95 |
| New MexicoNew Mexico | $393.10 | $122.35 |
| NevadaNevada | $417.67 | $122.11 |
| NYC suburbs and Long Island, NYNew York | $494.31 | $143.24 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $455.78 | $132.47 |
| Queens, NYNew York | $488.24 | $139.24 |
| Rest of New YorkNew York | $399.57 | $119.07 |
| OhioOhio | $390.04 | $120.46 |
| OklahomaOklahoma | $381.31 | $117.64 |
| Portland, OROregon | $454.64 | $126.60 |
| Rest of OregonOregon | $414.84 | $120.76 |
| Metropolitan Philadelphia, PAPennsylvania | $435.60 | $128.23 |
| Rest of PennsylvaniaPennsylvania | $391.13 | $120.07 |
| Puerto RicoPuerto Rico | $422.36 | $123.85 |
| Rhode IslandRhode Island | $430.31 | $125.30 |
| South CarolinaSouth Carolina | $392.26 | $119.44 |
| South DakotaSouth Dakota | $412.86 | $117.60 |
| TennesseeTennessee | $384.46 | $116.06 |
| Austin, TXTexas | $437.23 | $124.84 |
| Beaumont, TXTexas | $388.33 | $119.64 |
| Brazoria, TXTexas | $414.50 | $121.89 |
| Dallas, TXTexas | $416.94 | $122.86 |
| Fort Worth, TXTexas | $413.74 | $122.61 |
| Galveston, TXTexas | $415.59 | $122.40 |
| Houston, TXTexas | $420.54 | $127.34 |
| Rest of TexasTexas | $401.04 | $120.83 |
| UtahUtah | $398.01 | $120.46 |
| VirginiaVirginia | $410.55 | $120.31 |
| Virgin Islands, VIUnited States Virgin Islands | $422.36 | $123.85 |
| VermontVermont | $411.07 | $118.76 |
| Rest of WashingtonWashington | $435.30 | $124.39 |
| King County, WAWashington | $496.45 | $134.16 |
| WisconsinWisconsin | $398.66 | $115.80 |
| West VirginiaWest Virginia | $379.24 | $122.66 |
| WyomingWyoming | $416.50 | $121.24 |
43239 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.
$367.66
$508.92
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $475.29 | 1 |
| AL | $373.43 | 1 |
| AR | $367.66 | 1 |
| AZ | $407.26 | 1 |
| CA | $447.86–$569.97 | 29 |
| CO | $439.05 | 1 |
| CT | $447.86 | 1 |
| DC | $483.17 | 1 |
| DE | $414.34 | 1 |
| FL | $408.78–$446.25 | 3 |
| GA | $384.72–$426.21 | 2 |
| GU | $460.54 | 1 |
| HI | $460.54 | 1 |
| IA | $385.19 | 1 |
| ID | $387.53 | 1 |
| IL | $395.04–$435.32 | 4 |
| IN | $389.98 | 1 |
| KS | $382.50 | 1 |
| KY | $381.23 | 1 |
| LA | $380.29–$400.49 | 2 |
| MA | $435.86–$485.46 | 2 |
| MD | $422.87–$483.17 | 3 |
| ME | $388.88–$412.53 | 2 |
| MI | $391.13–$413.41 | 2 |
| MN | $422.13 | 1 |
| MO | $372.80–$402.93 | 3 |
| MS | $370.34 | 1 |
| MT | $418.83 | 1 |
| NC | $393.35 | 1 |
| ND | $413.49 | 1 |
| NE | $387.67 | 1 |
| NH | $431.33 | 1 |
| NJ | $453.38–$477.48 | 2 |
| NM | $393.10 | 1 |
| NV | $417.67 | 1 |
| NY | $399.57–$494.31 | 5 |
| OH | $390.04 | 1 |
| OK | $381.31 | 1 |
| OR | $414.84–$454.64 | 2 |
| PA | $391.13–$435.60 | 2 |
| PR | $422.36 | 1 |
| RI | $430.31 | 1 |
| SC | $392.26 | 1 |
| SD | $412.86 | 1 |
| TN | $384.46 | 1 |
| TX | $388.33–$437.23 | 8 |
| UT | $398.01 | 1 |
| VA | $410.55–$483.17 | 2 |
| VI | $422.36 | 1 |
| VT | $411.07 | 1 |
| WA | $435.30–$496.45 | 2 |
| WI | $398.66 | 1 |
| WV | $379.24 | 1 |
| WY | $416.50 | 1 |
How the 43239 rate is calculated
Each of 43239’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 · 43239
RVUs × geographic indexes × conversion factor
Work2.33
2.33 RVUs× 1.000 GPCI
Practice expense9.94
9.94 RVUs× 1.000 GPCI
Malpractice0.27
0.27 RVUs× 1.000 GPCI
Adjusted RVUs
12.5400
Conversion factor
$33.4009
Medicare rate
$418.85
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact North Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,167
- Code
- 43239
- Physician work
- 2.33
- Practice expense
- 9.94
- Malpractice
- 0.27
GPCI2026.csv
84
- Locality
- North Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.33 | × 1.000 | 2.3300 |
| Practice expense | 9.94 | × 1.000 | 9.9400 |
| Malpractice | 0.27 | × 0.406 | 0.1096 |
| Total RVUs | 12.3796 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Dakota$413.49
Office: (2.33 × 1 + 9.94 × 1 + 0.27 × 0.406) × $33.4009 = $413.49
Facility: (2.33 × 1 + 1.1 × 1 + 0.27 × 0.406) × $33.4009 = $118.23
Payment rules and modifiers for 43239
The CMS indicators that decide how 43239 is paid alongside other services.
CMS payment indicators · 43239
EGD with biopsy, single or multiple biopsies
| 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
43239 without 51 · national office
$418.85
EGD with biopsy, single or multiple biopsies
43239-51 · Second procedure: 50%
$209.43
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 43239 has changed in North Dakota
43239 · Office / nonfacility
$413.49
Effective 2026-10-01
The base rate is $60.92 higher than on 2025-10-01, moving from $352.57 to $413.49 (17.3%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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, 2026
RVU26A
$352.57changed to$413.49
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.39 changed to 2.33
- Practice expense RVU 8.36 changed to 9.94
- Malpractice RVU 0.29 changed to 0.27
- Malpractice GPCI 0.517 changed to 0.406
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$370.66changed to$352.57
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 8.59 changed to 8.36
- Malpractice RVU 0.30 changed to 0.29
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$364.61changed to$370.66
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$379.11changed to$364.61
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.66 changed to 8.59
- Malpractice RVU 0.29 changed to 0.30
- Malpractice GPCI 0.474 changed to 0.517
January 1, 2023
RVU23A
$397.15changed to$379.11
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 8.97 changed to 8.66
- Malpractice RVU 0.27 changed to 0.29
- Malpractice GPCI 0.431 changed to 0.474
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$395.76changed to$397.15
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.84 changed to 8.97
- Malpractice RVU 0.26 changed to 0.27
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$378.43changed to$395.76
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 7.96 changed to 8.84
- Malpractice RVU 0.28 changed to 0.26
- Malpractice GPCI 0.485 changed to 0.431
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$361.93changed to$378.43
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 7.48 changed to 7.96
- Malpractice RVU 0.32 changed to 0.28
- Malpractice GPCI 0.540 changed to 0.485
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$346.94changed to$361.93
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 7.08 changed to 7.48
- Malpractice RVU 0.31 changed to 0.32
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$343.99changed to$346.94
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 7.02 changed to 7.08
- Malpractice RVU 0.32 changed to 0.31
- Malpractice GPCI 0.547 changed to 0.540
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$398.44changed to$343.99
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 2.49 changed to 2.39
- Practice expense RVU 8.45 changed to 7.02
- Malpractice RVU 0.34 changed to 0.32
- Malpractice GPCI 0.554 changed to 0.547
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$406.75changed to$398.44
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 8.63 changed to 8.45
- Malpractice RVU 0.36 changed to 0.34
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$404.72changed to$406.75
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$399.86changed to$404.72
- Conversion factor 35.8228 changed to 35.7547
- Work RVU 2.47 changed to 2.49
- Practice expense RVU 8.51 changed to 8.63
- Malpractice RVU 0.34 changed to 0.36
- Malpractice GPCI 0.536 changed to 0.554
Held through RVU15B.
January 1, 2014
RVU14A
$352.38changed to$399.86
- Conversion factor 34.0230 changed to 35.8228
- Work RVU 2.87 changed to 2.47
- Practice expense RVU 7.27 changed to 8.51
- Malpractice RVU 0.42 changed to 0.34
- Malpractice GPCI 0.517 changed to 0.536
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $352.38
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $413.49 | $118.23 | RVU26D |
| 2026-07-01 | $413.49 | $118.23 | RVU26C |
| 2026-04-01 | $413.49 | $118.23 | RVU26B |
| 2026-01-01 | $413.49 | $118.23 | RVU26A |
| 2025-10-01 | $352.57 | $128.09 | RVU25D |
| 2025-07-01 | $352.57 | $128.09 | RVU25C |
| 2025-04-01 | $352.57 | $128.09 | RVU25B |
| 2025-01-01 | $352.57 | $128.09 | RVU25A |
| 2024-10-01 | $370.66 | $131.66 | RVU24D |
| 2024-07-01 | $370.66 | $131.66 | RVU24C |
| 2024-04-01 | $370.66 | $131.66 | RVU24B |
| 2024-03-09 | $370.66 | $131.66 | RVU24AR |
| 2024-01-01 | $364.61 | $129.51 | RVU24A |
| 2023-10-01 | $379.11 | $132.41 | RVU23D |
| 2023-07-01 | $379.11 | $132.41 | RVU23C |
| 2023-04-01 | $379.11 | $132.41 | RVU23B |
| 2023-01-01 | $379.11 | $132.41 | RVU23A |
| 2022-10-01 | $397.15 | $134.49 | RVU22D |
| 2022-07-01 | $397.15 | $134.49 | RVU22C |
| 2022-04-01 | $397.15 | $134.49 | RVU22B |
| 2022-01-01 | $397.15 | $134.49 | RVU22A |
| 2021-10-01 | $395.76 | $135.11 | RVU21D |
| 2021-07-01 | $395.76 | $135.11 | RVU21C |
| 2021-04-01 | $395.76 | $135.11 | RVU21B |
| 2021-01-01 | $395.76 | $135.11 | RVU21A |
| 2020-10-01 | $378.43 | $138.79 | RVU20D |
| 2020-07-01 | $378.43 | $138.79 | RVU20C |
| 2020-04-01 | $378.43 | $138.79 | RVU20B |
| 2020-01-01 | $378.43 | $138.79 | RVU20A |
| 2019-10-01 | $361.93 | $140.65 | RVU19D |
| 2019-07-01 | $361.93 | $140.65 | RVU19C |
| 2019-04-01 | $361.93 | $140.65 | RVU19B |
| 2019-01-01 | $361.93 | $140.65 | RVU19A |
| 2018-10-01 | $346.94 | $141.02 | RVU18D |
| 2018-07-01 | $346.94 | $141.02 | RVU18C |
| 2018-04-01 | $346.94 | $141.02 | RVU18B |
| 2018-01-01 | $346.94 | $141.02 | RVU18AR1 |
| 2017-10-01 | $343.99 | $141.22 | RVU17D |
| 2017-07-01 | $343.99 | $141.22 | RVU17C |
| 2017-04-01 | $343.99 | $141.22 | RVU17B |
| 2017-01-01 | $343.99 | $141.22 | RVU17A |
| 2016-10-01 | $398.44 | $146.02 | RVU16D |
| 2016-07-01 | $398.44 | $146.02 | RVU16C |
| 2016-04-01 | $398.44 | $146.02 | RVU16B |
| 2016-01-01 | $398.44 | $146.02 | RVU16A |
| 2015-10-01 | $406.75 | $148.39 | RVU15D |
| 2015-07-01 | $406.75 | $148.39 | RVU15C |
| 2015-04-01 | $404.72 | $147.65 | RVU15B |
| 2015-01-01 | $404.72 | $147.65 | RVU15A |
| 2014-10-01 | $399.86 | $146.60 | RVU14D |
| 2014-07-01 | $399.86 | $146.60 | RVU14C |
| 2014-04-01 | $399.86 | $146.60 | RVU14B |
| 2014-01-01 | $399.86 | $146.60 | RVU14A |
| 2013-10-01 | $352.38 | $167.64 | RVU13D |
| 2013-07-01 | $352.38 | $167.64 | RVU13C |
| 2013-04-01 | $352.38 | $167.64 | RVU13B |
| 2013-01-01 | $352.38 | $167.64 | RVU13AR |
Where the North Dakota rate applies
North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.
- Abercrombie
- Adams
- Alamo
- Alexander
- Alice
- Almont
- Alsen
- Ambrose
43239 billing questions
How many units are reported when biopsies are taken from the esophagus, stomach, and duodenum?
One unit. The code covers single or multiple biopsies from any number of sites during the same EGD session.
Can the diagnostic EGD be billed along with the biopsy code?
No. Diagnostic EGD is included in the biopsy procedure and is not reported separately for the same examination.
Can a biopsy be billed with snare polypectomy during the same EGD?
Yes, if the biopsy samples a different lesion and both procedures are documented. Use a distinct-procedure modifier such as 59 or XS when needed; a biopsy of the lesion subsequently removed by snare is not separately reported.
How is payment calculated when a biopsy and a dilation are both done at the same EGD?
If both are separately reportable procedures in the same endoscopy family, the higher-valued procedure is paid in full. Payment for the other is reduced by the value of the diagnostic base endoscopy.
Is the pathology examination of the biopsy included?
No. The pathologist bills the tissue examination, typically with a surgical pathology code such as 88305, separately from the endoscopy.
Does the 0-day global period bundle a preprocedure office visit on an earlier date?
No. The 0-day global period includes same-day preprocedure and postprocedure care, not a visit on an earlier date.
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
Fee sheets
Put 43239 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet