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CPT code 43248: Esophageal dilation, guidewire-assisted2026 Medicare rate & RVUs in Baltimore area, MD

Report guidewire-assisted esophageal dilation during upper endoscopy when a dilator is advanced over a wire to treat an esophageal narrowing.

CMS RVU26DEffective Oct 1, 2026One payment locality122.8K Medicare services in 2024

In Baltimore area, MD, Medicare pays $487.81 for 43248 in the office and $155.22 when it’s performed in a hospital or facility.

$487.81Office (non-facility)
$155.22Hospital or facility
+6.5%vs the national office rate ($457.93)

Check a contract rate as a % of Medicare · 43248 nationwide

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

We’ll open 43248 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Baltimore area, MD
  2. What 43248 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Baltimore area, MD compares for 43248

Across 109 of 109 payment localities, the office rate for 43248 runs from $402.83 in Arkansas to $618.55 in San Benito County, CA. Baltimore area, MD pays $487.81. The RVUs are the same everywhere; the geographic indexes change the dollars.

43248 in Baltimore area, MD vs other payment areas
  1. Baltimore area, MD · this page$487.81
  2. Rest of Maryland · Maryland$462.16−$25.65
  3. Los Angeles, CA · California$522.36+$34.55
  4. Washington, DC area · District of Columbia$526.94+$39.13
  5. Miami, FL · Florida$489.71+$1.90
  6. Chicago, IL · Illinois$475.06−$12.75
  7. Manhattan, NY · New York$527.63+$39.82

Other areas in Maryland first, then benchmark localities. Bars start at $0.

Every other payment area

43248 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$523.12$193.01
AlabamaAlabama$409.03$137.82
ArkansasArkansas$402.83$136.57
ArizonaArizona$445.39$145.04
Bakersfield, CACalifornia$489.05$149.34
Chico, CACalifornia$488.03$148.32
El Centro, CACalifornia$488.09$148.37
Fresno, CACalifornia$488.03$148.32

43248 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$402.83

$553.29

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
43248 office rate range by state
State / territoryOffice rate rangeLocalities
AK$523.121
AL$409.031
AR$402.831
AZ$445.391
CA$488.03–$618.5529
CO$479.091
CT$489.291
DC$526.941
DE$453.031
FL$448.16–$489.713
GA$422.12–$466.122
GU$501.331
HI$501.331
IA$421.181
ID$423.801
IL$433.72–$476.854
IN$426.411
KS$418.531
KY$417.921
LA$417.00–$438.722
MA$475.78–$528.802
MD$462.16–$526.943
ME$425.50–$450.572
MI$428.79–$453.412
MN$460.131
MO$409.09–$441.073
MS$406.071
MT$457.901
NC$430.261
ND$451.181
NE$423.781
NH$470.931
NJ$495.18–$520.952
NM$431.021
NV$456.381
NY$436.97–$540.205
OH$427.421
OK$417.761
OR$453.15–$495.582
PA$428.46–$476.252
PR$461.621
RI$470.111
SC$429.491
SD$450.391
TN$420.661
TX$425.47–$477.228
UT$435.671
VA$448.61–$526.942
VI$461.621
VT$448.801
WA$475.09–$540.432
WI$435.301
WV$416.751
WY$454.971

See 43248 in every payment locality

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.

How the rate is built · 43248

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.84

2.84 RVUs× 1.000 GPCI

Practice expense10.53

10.53 RVUs× 1.000 GPCI

Malpractice0.34

0.34 RVUs× 1.000 GPCI

Adjusted RVUs

13.7100

Conversion factor

$33.4009

Medicare rate

$457.93

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Baltimore area, MD inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,176

Code
43248
Physician work
2.84
Practice expense
10.53
Malpractice
0.34

GPCI2026.csv

60

Locality
Baltimore area, MD
Physician work
1.016
Practice expense
1.073
Malpractice
1.237
Office calculation for 43248 in Baltimore area, MD
ComponentRVULocality factorAdjusted
Physician work2.84× 1.0162.8854
Practice expense10.53× 1.07311.2987
Malpractice0.34× 1.2370.4206
Total RVUs14.6047
Conversion factor× 33.4009

Office rate, Baltimore area, MD$487.81

Office: (2.84 × 1.016 + 10.53 × 1.073 + 0.34 × 1.237) × $33.4009 = $487.81

Facility: (2.84 × 1.016 + 1.25 × 1.073 + 0.34 × 1.237) × $33.4009 = $155.22

Open 43248 in the RVU calculator

Payment rules and modifiers for 43248

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

CMS payment indicators · 43248

Esophageal dilation, guidewire-assisted

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

43248 without 51 · national office

$457.93

Esophageal dilation, guidewire-assisted

43248-51 · Second procedure: 50%

$228.97

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%).

When to use modifier 51

Codes related to 43248

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

Codes related to 43248
CodeHow it relatesOffice range, Baltimore area, MD
Used instead
43249Esophageal dilation, balloon under 30 mmEsophageal dilation by balloon rather than over a guide wire.$1,263.25

How 43248 has changed in Baltimore area, MD

43248 · Office / nonfacility

$487.81

Effective 2026-10-01

The base rate is $66.91 higher than on 2025-10-01, moving from $420.90 to $487.81 (15.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $420.90changed to$487.81

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.91 changed to 2.84
    • Practice expense RVU 8.88 changed to 10.53
    • Malpractice RVU 0.36 changed to 0.34
    • Work GPCI 1.020 changed to 1.016
    • Practice expense GPCI 1.078 changed to 1.073
    • Malpractice GPCI 1.309 changed to 1.237

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $441.39changed to$420.90

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.11 changed to 8.88

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $434.19changed to$441.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $454.31changed to$434.19

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.17 changed to 9.11
    • Malpractice RVU 0.35 changed to 0.36
    • Work GPCI 1.024 changed to 1.020
    • Practice expense GPCI 1.087 changed to 1.078
    • Malpractice GPCI 1.311 changed to 1.309

  5. January 1, 2023

    RVU23A

    $477.70changed to$454.31

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.47 changed to 9.17
    • Malpractice RVU 0.33 changed to 0.35
    • Work GPCI 1.028 changed to 1.024
    • Practice expense GPCI 1.096 changed to 1.087
    • Malpractice GPCI 1.313 changed to 1.311

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $470.11changed to$477.70

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.18 changed to 9.47
    • Malpractice RVU 0.32 changed to 0.33

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $432.63changed to$470.11

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.84 changed to 9.18
    • Work GPCI 1.026 changed to 1.028
    • Practice expense GPCI 1.095 changed to 1.096
    • Malpractice GPCI 1.304 changed to 1.313

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $410.34changed to$432.63

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.23 changed to 7.84
    • Malpractice RVU 0.38 changed to 0.32
    • Work GPCI 1.023 changed to 1.026
    • Malpractice GPCI 1.295 changed to 1.304

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $388.53changed to$410.34

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.70 changed to 7.23
    • Malpractice RVU 0.37 changed to 0.38

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $385.69changed to$388.53

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.66 changed to 6.70
    • Malpractice RVU 0.38 changed to 0.37
    • Practice expense GPCI 1.096 changed to 1.095
    • Malpractice GPCI 1.238 changed to 1.295

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $448.81changed to$385.69

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 3.01 changed to 2.91
    • Practice expense RVU 8.20 changed to 6.66
    • Malpractice RVU 0.39 changed to 0.38
    • Practice expense GPCI 1.097 changed to 1.096
    • Malpractice GPCI 1.181 changed to 1.238

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $459.65changed to$448.81

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.38 changed to 8.20
    • Malpractice RVU 0.44 changed to 0.39

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $457.36changed to$459.65

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $453.84changed to$457.36

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.29 changed to 8.38
    • Malpractice RVU 0.41 changed to 0.44
    • Work GPCI 1.025 changed to 1.023
    • Malpractice GPCI 1.194 changed to 1.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$453.84

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$487.81$155.22RVU26D
2026-07-01$487.81$155.22RVU26C
2026-04-01$487.81$155.22RVU26B
2026-01-01$487.81$155.22RVU26A
2025-10-01$420.90$168.79RVU25D
2025-07-01$420.90$168.79RVU25C
2025-04-01$420.90$168.79RVU25B
2025-01-01$420.90$168.79RVU25A
2024-10-01$441.39$173.34RVU24D
2024-07-01$441.39$173.34RVU24C
2024-04-01$441.39$173.34RVU24B
2024-03-09$441.39$173.34RVU24AR
2024-01-01$434.19$170.51RVU24A
2023-10-01$454.31$175.83RVU23D
2023-07-01$454.31$175.83RVU23C
2023-04-01$454.31$175.83RVU23B
2023-01-01$454.31$175.83RVU23A
2022-10-01$477.70$179.58RVU22D
2022-07-01$477.70$179.58RVU22C
2022-04-01$477.70$179.58RVU22B
2022-01-01$477.70$179.58RVU22A
2021-10-01$470.11$180.23RVU21D
2021-07-01$470.11$180.23RVU21C
2021-04-01$470.11$180.23RVU21B
2021-01-01$470.11$180.23RVU21A
2020-10-01$432.63$184.06RVU20D
2020-07-01$432.63$184.06RVU20C
2020-04-01$432.63$184.06RVU20B
2020-01-01$432.63$184.06RVU20A
2019-10-01$410.34$186.98RVU19D
2019-07-01$410.34$186.98RVU19C
2019-04-01$410.34$186.98RVU19B
2019-01-01$410.34$186.98RVU19A
2018-10-01$388.53$187.49RVU18D
2018-07-01$388.53$187.49RVU18C
2018-04-01$388.53$187.49RVU18B
2018-01-01$388.53$187.49RVU18AR1
2017-10-01$385.69$186.26RVU17D
2017-07-01$385.69$186.26RVU17C
2017-04-01$385.69$186.26RVU17B
2017-01-01$385.69$186.26RVU17A
2016-10-01$448.81$191.16RVU16D
2016-07-01$448.81$191.16RVU16C
2016-04-01$448.81$191.16RVU16B
2016-01-01$448.81$191.16RVU16A
2015-10-01$459.65$195.94RVU15D
2015-07-01$459.65$195.94RVU15C
2015-04-01$457.36$194.96RVU15B
2015-01-01$457.36$194.96RVU15A
2014-10-01$453.84$195.26RVU14D
2014-07-01$453.84$195.26RVU14C
2014-04-01$453.84$195.26RVU14B
2014-01-01$453.84$195.26RVU14A
2013-10-01Not available in this setting$203.55RVU13D
2013-07-01Not available in this setting$203.55RVU13C
2013-04-01Not available in this setting$203.55RVU13B
2013-01-01Not available in this setting$203.55RVU13AR

Price 43248 for an earlier date of service

Where the Baltimore area, MD rate applies

Baltimore area, MD is a Medicare payment area, not a city. Our Census mapping connects it to 100 cities and communities in Maryland. Some span more than one payment area; confirm with the service ZIP.

  • Baltimore
  • Aberdeen
  • Aberdeen Proving Ground
  • Abingdon
  • Annapolis
  • Annapolis Neck
  • Arbutus
  • Arden on the Severn

Browse all communities in Maryland

43248 billing questions

How does this differ from code 43249?

Code 43248 represents dilation over a guide wire. Code 43249 is used for esophageal balloon dilation with a balloon smaller than 30 mm.

Can the diagnostic EGD be reported separately?

The endoscopic inspection is part of the therapeutic procedure when performed to guide the dilation. Do not separately report a diagnostic EGD for that same work.

What documentation supports code 43248?

Document the esophageal narrowing treated and that dilation was performed over a guide wire. The record should support that the service was not balloon dilation.

Should modifier 50 be appended?

No. Bilateral adjustment is inappropriate for this service, so modifier 50 should not be used.

How are related endoscopies handled when performed in the same session?

CMS endoscopy-family pricing applies when related endoscopies are performed together. The procedure has a 0-day global period, with same-day preoperative and postoperative care included.

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
RVUs for 43248PPRRVU2026_Oct_nonQPP.csv, line 5,176 (RVU26D)
Geographic factors for Baltimore area, MDGPCI2026.csv, line 60 (RVU26D)

Open CMS sourceHow we calculate rates

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