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CPT code 43453: Esophageal dilation, balloon with fluoroscopy2026 Medicare rate & RVUs in Delaware

Reports balloon dilation of an esophageal narrowing when the catheter is positioned and the procedure is performed with fluoroscopic guidance.

CMS RVU26DEffective Oct 1, 2026One payment locality1.4K Medicare services in 2024

In Delaware, Medicare pays $821.95 for 43453 in the office and $76.80 when it’s performed in a hospital or facility.

$821.95Office (non-facility)
$76.80Hospital or facility
−1.2%vs the national office rate ($831.68)

Check a contract rate as a % of Medicare · 43453 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 43453 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 43453 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 43453 covers

This service enlarges a narrowed segment of the esophagus by inflating a balloon catheter under fluoroscopic guidance. It may be used for conditions such as a benign stricture, ring, or web that limits passage through the esophagus. A gastroenterologist or interventional radiologist typically performs the dilation in a hospital or outpatient procedure setting. The fluoroscopic balloon approach distinguishes this service from dilation performed through an endoscope or with an unguided bougie.

Report the service when the esophageal dilation uses a balloon catheter with fluoroscopic guidance. Documentation should identify the narrowing and its location, the balloon-catheter technique, and the fluoroscopic guidance used. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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 Delaware compares for 43453

Across 109 of 109 payment localities, the office rate for 43453 runs from $718.80 in Arkansas to $1,178.65 in San Benito County, CA. Delaware pays $821.95. The RVUs are the same everywhere; the geographic indexes change the dollars.

43453 in Delaware vs other payment areas
  1. Delaware · this page$821.95
  2. Los Angeles, CA · California$974.26+$152.31
  3. Washington, DC area · District of Columbia$973.66+$151.71
  4. Miami, FL · Florida$872.85+$50.90
  5. Chicago, IL · Illinois$843.69+$21.74
  6. Manhattan, NY · New York$964.48+$142.53
  7. Alaska · Alaska$902.56+$80.61

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

Every other payment area

43453 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$731.58$71.67
ArkansasArkansas$718.80$70.95
ArizonaArizona$806.64$75.83
Bakersfield, CACalifornia$905.07$78.48
Chico, CACalifornia$904.54$77.95
El Centro, CACalifornia$904.57$77.98
Fresno, CACalifornia$904.54$77.95
Hanford, CACalifornia$904.54$77.95

43453 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.

$718.80

$1,041.60

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

View every state and territory as a table
43453 office rate range by state
State / territoryOffice rate rangeLocalities
AK$902.561
AL$731.581
AR$718.801
AZ$806.641
CA$904.54–$1,178.6529
CO$880.831
CT$893.911
DC$973.661
DE$821.951
FL$800.39–$872.853
GA$748.61–$845.512
GU$936.001
HI$936.001
IA$761.761
ID$766.121
IL$767.21–$857.704
IN$771.661
KS$753.831
KY$744.601
LA$741.74–$786.492
MA$872.53–$984.202
MD$841.01–$973.663
ME$767.02–$822.442
MI$764.61–$808.512
MN$850.071
MO$723.90–$794.263
MS$721.711
MT$831.671
NC$777.261
ND$828.111
NE$767.891
NH$862.911
NJ$905.85–$959.762
NM$768.161
NV$831.461
NY$790.90–$987.175
OH$763.881
OK$746.891
OR$826.78–$917.452
PA$767.40–$865.642
PR$840.171
RI$857.641
SC$771.511
SD$827.691
TN$757.931
TX$761.06–$876.328
UT$784.271
VA$816.66–$973.662
VI$840.171
VT$820.911
WA$872.18–$1,009.912
WI$794.771
WV$732.111
WY$830.121

See 43453 in every payment locality

How the 43453 rate is calculated

Each of 43453’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 · 43453

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.37

1.37 RVUs× 1.000 GPCI

Practice expense23.35

23.35 RVUs× 1.000 GPCI

Malpractice0.18

0.18 RVUs× 1.000 GPCI

Adjusted RVUs

24.9000

Conversion factor

$33.4009

Medicare rate

$831.68

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,251

Code
43453
Physician work
1.37
Practice expense
23.35
Malpractice
0.18

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 43453 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.37× 1.0051.3768
Practice expense23.35× 0.98823.0698
Malpractice0.18× 0.8990.1618
Total RVUs24.6085
Conversion factor× 33.4009

Office rate, Delaware$821.95

Office: (1.37 × 1.005 + 23.35 × 0.988 + 0.18 × 0.899) × $33.4009 = $821.95

Facility: (1.37 × 1.005 + 0.77 × 0.988 + 0.18 × 0.899) × $33.4009 = $76.80

Open 43453 in the RVU calculator

Payment rules and modifiers for 43453

The CMS indicators that decide how 43453 is paid alongside other services.

CMS payment indicators · 43453

Esophageal dilation, balloon with fluoroscopy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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

43453 without 51 · national office

$831.68

Esophageal dilation, balloon with fluoroscopy

43453-51 · Second procedure: 50%

$415.84

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 43453

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

Codes related to 43453
CodeHow it relatesOffice range, Delaware
Used instead
43450Esophageal dilation, unguided sound or bougieEsophageal dilation by unguided sound or bougie rather than fluoroscopic balloon catheter.$209.81
43249Esophageal dilation, balloon under 30 mmEndoscopic balloon dilation for an esophageal narrowing, using a balloon under 30 mm.$1,166.81
43233Esophageal dilation, balloon 30 mm or largerEndoscopic balloon dilation for an esophageal narrowing, using a balloon 30 mm or larger.No office rate

How 43453 has changed in Delaware

43453 · Office / nonfacility

$821.95

Effective 2026-10-01

The base rate is $90.15 higher than on 2025-10-01, moving from $731.80 to $821.95 (12.3%).

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

    $731.80changed to$821.95

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.41 changed to 1.37
    • Practice expense RVU 21.20 changed to 23.35
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $784.12changed to$731.80

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 22.13 changed to 21.20
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $771.32changed to$784.12

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $828.44changed to$771.32

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 22.69 changed to 22.13
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $890.55changed to$828.44

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 23.63 changed to 22.69
    • Malpractice RVU 0.18 changed to 0.19
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $949.71changed to$890.55

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 25.10 changed to 23.63
    • Malpractice RVU 0.16 changed to 0.18

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $923.01changed to$949.71

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 23.50 changed to 25.10
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $934.70changed to$923.01

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 23.85 changed to 23.50
    • Malpractice RVU 0.19 changed to 0.16
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $953.45changed to$934.70

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 24.40 changed to 23.85
    • Malpractice RVU 0.18 changed to 0.19

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $947.71changed to$953.45

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 24.18 changed to 24.40
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1012.99changed to$947.71

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.51 changed to 1.41
    • Practice expense RVU 25.76 changed to 24.18
    • Malpractice RVU 0.19 changed to 0.18
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1033.74changed to$1012.99

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 26.19 changed to 25.76
    • Malpractice RVU 0.22 changed to 0.19

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $1028.60changed to$1033.74

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1026.22changed to$1028.60

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 25.94 changed to 26.19
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $320.45changed to$1026.22

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.41 changed to 25.94
    • Malpractice RVU 0.23 changed to 0.22
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $320.45

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$821.95$76.80RVU26D
2026-07-01$821.95$76.80RVU26C
2026-04-01$821.95$76.80RVU26B
2026-01-01$821.95$76.80RVU26A
2025-10-01$731.80$83.63RVU25D
2025-07-01$731.80$83.63RVU25C
2025-04-01$731.80$83.63RVU25B
2025-01-01$731.80$83.63RVU25A
2024-10-01$784.12$85.72RVU24D
2024-07-01$784.12$85.72RVU24C
2024-04-01$784.12$85.72RVU24B
2024-03-09$784.12$85.72RVU24AR
2024-01-01$771.32$84.32RVU24A
2023-10-01$828.44$86.57RVU23D
2023-07-01$828.44$86.57RVU23C
2023-04-01$828.44$86.57RVU23B
2023-01-01$828.44$86.57RVU23A
2022-10-01$890.55$88.06RVU22D
2022-07-01$890.55$88.06RVU22C
2022-04-01$890.55$88.06RVU22B
2022-01-01$890.55$88.06RVU22A
2021-10-01$949.71$87.79RVU21D
2021-07-01$949.71$87.79RVU21C
2021-04-01$949.71$87.79RVU21B
2021-01-01$949.71$87.79RVU21A
2020-10-01$923.01$90.26RVU20D
2020-07-01$923.01$90.26RVU20C
2020-04-01$923.01$90.26RVU20B
2020-01-01$923.01$90.26RVU20A
2019-10-01$934.70$91.88RVU19D
2019-07-01$934.70$91.88RVU19C
2019-04-01$934.70$91.88RVU19B
2019-01-01$934.70$91.88RVU19A
2018-10-01$953.45$92.11RVU18D
2018-07-01$953.45$92.11RVU18C
2018-04-01$953.45$92.11RVU18B
2018-01-01$953.45$92.11RVU18AR1
2017-10-01$947.71$92.43RVU17D
2017-07-01$947.71$92.43RVU17C
2017-04-01$947.71$92.43RVU17B
2017-01-01$947.71$92.43RVU17A
2016-10-01$1,012.99$97.89RVU16D
2016-07-01$1,012.99$97.89RVU16C
2016-04-01$1,012.99$97.89RVU16B
2016-01-01$1,012.99$97.89RVU16A
2015-10-01$1,033.74$100.52RVU15D
2015-07-01$1,033.74$100.52RVU15C
2015-04-01$1,028.60$100.02RVU15B
2015-01-01$1,028.60$100.02RVU15A
2014-10-01$1,026.22$99.22RVU14D
2014-07-01$1,026.22$99.22RVU14C
2014-04-01$1,026.22$99.22RVU14B
2014-01-01$1,026.22$99.22RVU14A
2013-10-01$320.45$97.74RVU13D
2013-07-01$320.45$97.74RVU13C
2013-04-01$320.45$97.74RVU13B
2013-01-01$320.45$97.74RVU13AR

Price 43453 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

43453 billing questions

How does this differ from 43450?

43453 is for balloon-catheter dilation under fluoroscopic guidance. 43450 describes dilation with an unguided sound or bougie.

When would an endoscopic dilation code be more appropriate?

Use an endoscopic dilation code when dilation is performed through an endoscope. For example, 43249 and 43233 distinguish endoscopic balloon dilation by balloon diameter.

Is same-day postoperative care separately reported?

Same-day preoperative and postoperative care is included in this service's 0-day global period.

Can modifier 50 be used for dilation on both sides?

No. The code's descriptor or anatomy makes bilateral adjustment inappropriate.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple-procedure reduction.

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 43453PPRRVU2026_Oct_nonQPP.csv, line 5,251 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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