CPT code 43248: Esophageal dilation, guidewire-assisted2026 Medicare rate & RVUs

Medicare pays $457.93 for 43248 nationally in the office and $147.97 in a hospital or facility. Local office rates run $402.83–$618.55.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 43248 covers

During upper endoscopy, the physician passes a guide wire through the narrowed esophagus and advances a dilator over it to widen the passage. Gastroenterologists and other physicians trained in endoscopy commonly perform this for symptomatic esophageal strictures, such as narrowing that causes difficulty swallowing, in hospital outpatient departments and ambulatory surgery centers.

Choose this code when the documented dilation is performed over a guide wire; record the esophageal site, the narrowing treated, and the wire-guided technique. A balloon dilation of the esophagus is represented by a different code. This service 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 does not pay for an assistant at surgery, and co-surgeons and team surgery are not permitted 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.

Where 43248 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

43248 rates by state

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

How the 43248 rate is calculated

Each of 43248’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 43248

The CMS indicators that decide how 43248 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

43248 compared with similar codes

How to choose

43249Esophageal dilationBalloon under 30 mm

Use 43248 for dilation over a guide wire; use 43249 when the esophagus is dilated with a balloon smaller than 30 mm.

43245EGD dilationGastric outlet obstruction

Code 43245 describes dilation of the gastric outlet, not dilation of an esophageal narrowing.

43241Endoscopic tube placementIntraluminal tube or catheter

Code 43241 concerns placement of an intraluminal tube or catheter; it does not represent guidewire-assisted esophageal dilation.

Codes related to 43248

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

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