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CPT code 43255: Bleeding control, any endoscopic hemostasis method2026 Medicare rate & RVUs in Nevada

Reports upper endoscopic treatment to stop gastrointestinal bleeding, such as bleeding from an ulcer or other nonvariceal lesion.

CMS RVU26DEffective Oct 1, 2026One payment locality53.5K Medicare services in 2024

In Nevada, Medicare pays $687.45 for 43255 in the office and $174.90 when it’s performed in a hospital or facility.

$687.45Office (non-facility)
$174.90Hospital or facility
−0.2%vs the national office rate ($689.06)

Check a contract rate as a % of Medicare · 43255 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 43255 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 43255 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 43255 covers

A gastroenterologist or other qualified endoscopist uses an upper endoscope to treat a bleeding site in the esophagus, stomach, or duodenum. Examples include hemostasis of a bleeding peptic ulcer or a Dieulafoy lesion using clips, thermal treatment, or injection. The code represents an endoscopic attempt to control bleeding, not inspection alone; the procedure may occur during an urgent evaluation of hematemesis or upper gastrointestinal blood loss.

Report it when the endoscopist performs hemostasis and the record identifies the bleeding site, findings, and treatment method. Use the variceal injection or ligation codes when that specific variceal treatment is performed. 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 Nevada compares for 43255

Across 109 of 109 payment localities, the office rate for 43255 runs from $603.76 in Arkansas to $943.34 in San Benito County, CA. Nevada pays $687.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

43255 in Nevada vs other payment areas
  1. Nevada · this page$687.45
  2. Los Angeles, CA · California$791.94+$104.49
  3. Washington, DC area · District of Columbia$796.49+$109.04
  4. Miami, FL · Florida$731.94+$44.49
  5. Chicago, IL · Illinois$709.54+$22.09
  6. Manhattan, NY · New York$794.85+$107.40
  7. Alaska · Alaska$777.57+$90.12

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

Every other payment area

43255 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$613.39$165.36
ArkansasArkansas$603.76$163.93
ArizonaArizona$669.82$173.66
Bakersfield, CACalifornia$739.94$178.75
Chico, CACalifornia$738.76$177.57
El Centro, CACalifornia$738.82$177.63
Fresno, CACalifornia$738.76$177.57
Hanford, CACalifornia$738.76$177.57

43255 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.

$603.76

$841.05

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

View every state and territory as a table
43255 office rate range by state
State / territoryOffice rate rangeLocalities
AK$777.571
AL$613.391
AR$603.761
AZ$669.821
CA$738.76–$943.3429
CO$723.451
CT$737.241
DC$796.491
DE$681.601
FL$670.97–$731.943
GA$631.07–$700.992
GU$760.311
HI$760.311
IA$633.591
ID$637.391
IL$647.66–$715.054
IN$641.481
KS$628.831
KY$625.781
LA$624.10–$657.782
MA$717.96–$801.052
MD$695.87–$796.493
ME$639.33–$679.212
MI$642.01–$678.392
MN$696.131
MO$611.42–$662.203
MS$607.801
MT$689.031
NC$646.831
ND$681.321
NE$637.831
NH$710.401
NJ$746.49–$786.872
NM$645.191
NV$687.451
NY$657.19–$813.515
OH$640.431
OK$626.221
OR$682.95–$749.762
PA$642.41–$716.632
PR$695.031
RI$708.341
SC$644.541
SD$680.411
TN$632.061
TX$637.72–$720.308
UT$654.121
VA$675.71–$796.492
VI$695.031
VT$677.021
WA$717.14–$819.622
WI$656.521
WV$621.301
WY$685.671

See 43255 in every payment locality

How the 43255 rate is calculated

Each of 43255’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 · 43255

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.47

3.47 RVUs× 1.000 GPCI

Practice expense16.77

16.77 RVUs× 1.000 GPCI

Malpractice0.39

0.39 RVUs× 1.000 GPCI

Adjusted RVUs

20.6300

Conversion factor

$33.4009

Medicare rate

$689.06

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

The exact Nevada inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,184

Code
43255
Physician work
3.47
Practice expense
16.77
Malpractice
0.39

GPCI2026.csv

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 43255 in Nevada
ComponentRVULocality factorAdjusted
Physician work3.47× 1.0003.4700
Practice expense16.77× 1.00116.7868
Malpractice0.39× 0.8330.3249
Total RVUs20.5816
Conversion factor× 33.4009

Office rate, Nevada$687.45

Office: (3.47 × 1 + 16.77 × 1.001 + 0.39 × 0.833) × $33.4009 = $687.45

Facility: (3.47 × 1 + 1.44 × 1.001 + 0.39 × 0.833) × $33.4009 = $174.90

Open 43255 in the RVU calculator

Payment rules and modifiers for 43255

The CMS indicators that decide how 43255 is paid alongside other services.

CMS payment indicators · 43255

Bleeding control, any endoscopic hemostasis method

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

43255 without 51 · national office

$689.06

Bleeding control, any endoscopic hemostasis method

43255-51 · Second procedure: 50%

$344.53

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 43255

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

Codes related to 43255
CodeHow it relatesOffice range, Nevada
Used instead
43243Variceal injection, esophageal or gastric varicesUse for endoscopic injection treatment of bleeding esophageal varices.No office rate
43244Variceal ligation, esophageal or gastric varicesUse for endoscopic ligation treatment of esophageal varices.No office rate
43250Upper endoscopy, cautery lesion removalDescribes cautery treatment of a tumor or polyp rather than hemostasis as the primary service.$496.72
43251EGD lesion removal, snare techniqueDescribes snare removal of a lesion rather than endoscopic bleeding control.$544.02

How 43255 has changed in Nevada

43255 · Office / nonfacility

$687.45

Effective 2026-10-01

The base rate is $102.48 higher than on 2025-10-01, moving from $584.97 to $687.45 (17.5%).

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

    $584.97changed to$687.45

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.56 changed to 3.47
    • Practice expense RVU 14.17 changed to 16.77
    • Malpractice RVU 0.42 changed to 0.39
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $619.68changed to$584.97

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 14.71 changed to 14.17
    • Malpractice RVU 0.41 changed to 0.42

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $609.57changed to$619.68

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $641.49changed to$609.57

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 14.92 changed to 14.71
    • Malpractice GPCI 1.098 changed to 0.844

  5. January 1, 2023

    RVU23A

    $679.60changed to$641.49

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 15.52 changed to 14.92
    • Malpractice RVU 0.40 changed to 0.41
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $705.70changed to$679.60

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 16.12 changed to 15.52
    • Malpractice RVU 0.39 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $676.86changed to$705.70

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 14.74 changed to 16.12
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $684.28changed to$676.86

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 14.76 changed to 14.74
    • Malpractice RVU 0.45 changed to 0.39
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $691.18changed to$684.28

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 14.96 changed to 14.76
    • Malpractice RVU 0.46 changed to 0.45

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $694.59changed to$691.18

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 14.84 changed to 14.96
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $772.13changed to$694.59

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 3.66 changed to 3.56
    • Practice expense RVU 16.58 changed to 14.84
    • Malpractice RVU 0.47 changed to 0.46
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $460.96changed to$772.13

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.22 changed to 16.58
    • Malpractice RVU 0.52 changed to 0.47

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $458.67changed to$460.96

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $459.50changed to$458.67

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.14 changed to 8.22
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$459.50

    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$687.45$174.90RVU26D
2026-07-01$687.45$174.90RVU26C
2026-04-01$687.45$174.90RVU26B
2026-01-01$687.45$174.90RVU26A
2025-10-01$584.97$189.70RVU25D
2025-07-01$584.97$189.70RVU25C
2025-04-01$584.97$189.70RVU25B
2025-01-01$584.97$189.70RVU25A
2024-10-01$619.68$194.27RVU24D
2024-07-01$619.68$194.27RVU24C
2024-04-01$619.68$194.27RVU24B
2024-03-09$619.68$194.27RVU24AR
2024-01-01$609.57$191.10RVU24A
2023-10-01$641.49$200.28RVU23D
2023-07-01$641.49$200.28RVU23C
2023-04-01$641.49$200.28RVU23B
2023-01-01$641.49$200.28RVU23A
2022-10-01$679.60$208.61RVU22D
2022-07-01$679.60$208.61RVU22C
2022-04-01$679.60$208.61RVU22B
2022-01-01$679.60$208.61RVU22A
2021-10-01$705.70$208.82RVU21D
2021-07-01$705.70$208.82RVU21C
2021-04-01$705.70$208.82RVU21B
2021-01-01$705.70$208.82RVU21A
2020-10-01$676.86$211.30RVU20D
2020-07-01$676.86$211.30RVU20C
2020-04-01$676.86$211.30RVU20B
2020-01-01$676.86$211.30RVU20A
2019-10-01$684.28$211.47RVU19D
2019-07-01$684.28$211.47RVU19C
2019-04-01$684.28$211.47RVU19B
2019-01-01$684.28$211.47RVU19A
2018-10-01$691.18$212.66RVU18D
2018-07-01$691.18$212.66RVU18C
2018-04-01$691.18$212.66RVU18B
2018-01-01$691.18$212.66RVU18AR1
2017-10-01$694.59$214.03RVU17D
2017-07-01$694.59$214.03RVU17C
2017-04-01$694.59$214.03RVU17B
2017-01-01$694.59$214.03RVU17A
2016-10-01$772.13$220.47RVU16D
2016-07-01$772.13$220.47RVU16C
2016-04-01$772.13$220.47RVU16B
2016-01-01$772.13$220.47RVU16A
2015-10-01$460.96$225.68RVU15D
2015-07-01$460.96$225.68RVU15C
2015-04-01$458.67$224.55RVU15B
2015-01-01$458.67$224.55RVU15A
2014-10-01$459.50$227.45RVU14D
2014-07-01$459.50$227.45RVU14C
2014-04-01$459.50$227.45RVU14B
2014-01-01$459.50$227.45RVU14A
2013-10-01Not available in this setting$297.08RVU13D
2013-07-01Not available in this settingRate data unavailableRVU13C
2013-04-01Not available in this settingRate data unavailableRVU13B
2013-01-01Not available in this settingRate data unavailableRVU13AR

Price 43255 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

43255 billing questions

When should this code be chosen over the variceal treatment codes?

Use this code for endoscopic hemostasis such as treatment of a bleeding ulcer. Use 43243 for variceal injection or 43244 for variceal ligation.

Is diagnostic inspection included when hemostasis is performed?

The endoscopic examination that identifies the bleeding site is part of the therapeutic service; do not report a separate diagnostic upper endoscopy for that same session.

What documentation supports reporting this service?

Document the bleeding site and endoscopic findings, the hemostatic method used, and the result of treatment.

Can modifier 50 be used if treatment involves paired anatomy?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does Medicare price this with another related endoscopy?

Medicare applies endoscopy-family pricing when related endoscopies are performed together, rather than treating each as an independent full standalone service.

Does Medicare pay an assistant or co-surgeon for this procedure?

No. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.

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 43255PPRRVU2026_Oct_nonQPP.csv, line 5,184 (RVU26D)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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