CPT code 43270: Lesion ablation, upper GI endoscopy2026 Medicare rate & RVUs in South Dakota

In South Dakota, Medicare pays $792.87 for 43270 in the office and $187.97 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 43270 nationwide

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

What 43270 covers

During an upper endoscopy, a gastroenterologist or other qualified physician applies an ablative method to a tumor, polyp, or other lesion in the upper gastrointestinal tract. Examples include radiofrequency ablation of Barrett’s esophagus with dysplasia and argon plasma coagulation of selected mucosal lesions. The service is performed in settings equipped for therapeutic endoscopy, including hospital outpatient departments and ambulatory surgery centers.

Select this service when the lesion is treated by ablation rather than removed with a snare, hot biopsy forceps, or bipolar cautery. The report should identify the lesion’s location, the ablation performed, and the clinical reason for choosing ablation. CMS assigns 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 for this upper-GI service. CMS does not pay for an assistant at surgery, and co-surgeon and team-surgery reporting 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 South Dakota compares for 43270

Across 109 of 109 payment localities, the office rate for 43270 runs from $702.81 in Arkansas to $1,100.71 in San Benito County, CA. South Dakota pays $792.87. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

43270 rates by state

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

See 43270 in every payment locality

How the 43270 rate is calculated

Each of 43270’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 43270

The CMS indicators that decide how 43270 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 43270

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

How 43270 has changed in South Dakota

Price 43270 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

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