CPT code 43499: Esophageal procedure, unlisted2026 Medicare rate & RVUs in Colorado
Reports an esophageal procedure for which no specific CPT code describes the service; Medicare payment is set by the contractor.
CMS doesn’t publish a rate for 43499 in Colorado.
Check a contract rate as a % of Medicare · 43499 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 43499 covers
Code 43499 identifies an unlisted procedure involving the esophagus: the procedure performed does not have a more specific CPT code. It is selected based on the service actually performed, rather than as a substitute for a listed esophageal procedure that describes that service. Nearby listed codes address procedures such as esophageal vein ligation, repair, dilation, and transoral lower esophageal myotomy; those codes apply when their described procedure matches the work. The code is reported for the unlisted esophageal service.
Medicare assigns physician fee schedule status C, carrier priced. CMS publishes no national payment; the Medicare Administrative Contractor sets payment for each claim. The contractor also sets the global period. For multiple procedures performed in the same session, the highest-valued procedure is paid in full and the others at 50% under the stated multiple procedure rule. Report the code only for the unlisted esophageal service; select a specific esophageal code when it describes the procedure.
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 Colorado compares for 43499
- Colorado · this pageUnavailable
- Los Angeles, CA · CaliforniaUnavailable
- Washington, DC area · District of ColumbiaUnavailable
- Miami, FL · FloridaUnavailable
- Chicago, IL · IllinoisUnavailable
- Manhattan, NY · New YorkUnavailable
- Alaska · AlaskaUnavailable
Other areas in Colorado first, then benchmark localities. Bars start at $0.
Every other payment area
43499 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 43499 rate is calculated
Each of 43499’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 · 43499
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43499
The CMS indicators that decide how 43499 is paid alongside other services.
CMS payment indicators · 43499
Esophageal procedure, unlisted
| Rule | CMS value | What it means |
|---|---|---|
| Global period | YYY | The Medicare contractor sets the global period. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
43499 without 51 · national facility
$0.00
Esophageal procedure, unlisted
43499-51 · Second procedure: 50%
$0.00
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%).
How 43499 has changed in Colorado
43499 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Contractor-priced | Contractor-priced | RVU26D |
| 2026-07-01 | Contractor-priced | Contractor-priced | RVU26C |
| 2026-04-01 | Contractor-priced | Contractor-priced | RVU26B |
| 2026-01-01 | Contractor-priced | Contractor-priced | RVU26A |
| 2025-10-01 | Contractor-priced | Contractor-priced | RVU25D |
| 2025-07-01 | Contractor-priced | Contractor-priced | RVU25C |
| 2025-04-01 | Contractor-priced | Contractor-priced | RVU25B |
| 2025-01-01 | Contractor-priced | Contractor-priced | RVU25A |
| 2024-10-01 | Contractor-priced | Contractor-priced | RVU24D |
| 2024-07-01 | Contractor-priced | Contractor-priced | RVU24C |
| 2024-04-01 | Contractor-priced | Contractor-priced | RVU24B |
| 2024-03-09 | Contractor-priced | Contractor-priced | RVU24AR |
| 2024-01-01 | Contractor-priced | Contractor-priced | RVU24A |
| 2023-10-01 | Contractor-priced | Contractor-priced | RVU23D |
| 2023-07-01 | Contractor-priced | Contractor-priced | RVU23C |
| 2023-04-01 | Contractor-priced | Contractor-priced | RVU23B |
| 2023-01-01 | Contractor-priced | Contractor-priced | RVU23A |
| 2022-10-01 | Contractor-priced | Contractor-priced | RVU22D |
| 2022-07-01 | Contractor-priced | Contractor-priced | RVU22C |
| 2022-04-01 | Contractor-priced | Contractor-priced | RVU22B |
| 2022-01-01 | Contractor-priced | Contractor-priced | RVU22A |
| 2021-10-01 | Contractor-priced | Contractor-priced | RVU21D |
| 2021-07-01 | Contractor-priced | Contractor-priced | RVU21C |
| 2021-04-01 | Contractor-priced | Contractor-priced | RVU21B |
| 2021-01-01 | Contractor-priced | Contractor-priced | RVU21A |
| 2020-10-01 | Contractor-priced | Contractor-priced | RVU20D |
| 2020-07-01 | Contractor-priced | Contractor-priced | RVU20C |
| 2020-04-01 | Contractor-priced | Contractor-priced | RVU20B |
| 2020-01-01 | Contractor-priced | Contractor-priced | RVU20A |
| 2019-10-01 | Contractor-priced | Contractor-priced | RVU19D |
| 2019-07-01 | Contractor-priced | Contractor-priced | RVU19C |
| 2019-04-01 | Contractor-priced | Contractor-priced | RVU19B |
| 2019-01-01 | Contractor-priced | Contractor-priced | RVU19A |
| 2018-10-01 | Contractor-priced | Contractor-priced | RVU18D |
| 2018-07-01 | Contractor-priced | Contractor-priced | RVU18C |
| 2018-04-01 | Contractor-priced | Contractor-priced | RVU18B |
| 2018-01-01 | Contractor-priced | Contractor-priced | RVU18AR1 |
| 2017-10-01 | Contractor-priced | Contractor-priced | RVU17D |
| 2017-07-01 | Contractor-priced | Contractor-priced | RVU17C |
| 2017-04-01 | Contractor-priced | Contractor-priced | RVU17B |
| 2017-01-01 | Contractor-priced | Contractor-priced | RVU17A |
| 2016-10-01 | Contractor-priced | Contractor-priced | RVU16D |
| 2016-07-01 | Contractor-priced | Contractor-priced | RVU16C |
| 2016-04-01 | Contractor-priced | Contractor-priced | RVU16B |
| 2016-01-01 | Contractor-priced | Contractor-priced | RVU16A |
| 2015-10-01 | Contractor-priced | Contractor-priced | RVU15D |
| 2015-07-01 | Contractor-priced | Contractor-priced | RVU15C |
| 2015-04-01 | Contractor-priced | Contractor-priced | RVU15B |
| 2015-01-01 | Contractor-priced | Contractor-priced | RVU15A |
| 2014-10-01 | Contractor-priced | Contractor-priced | RVU14D |
| 2014-07-01 | Contractor-priced | Contractor-priced | RVU14C |
| 2014-04-01 | Contractor-priced | Contractor-priced | RVU14B |
| 2014-01-01 | Contractor-priced | Contractor-priced | RVU14A |
| 2013-10-01 | Contractor-priced | Contractor-priced | RVU13D |
| 2013-07-01 | Contractor-priced | Contractor-priced | RVU13C |
| 2013-04-01 | Contractor-priced | Contractor-priced | RVU13B |
| 2013-01-01 | Contractor-priced | Contractor-priced | RVU13AR |
Where the Colorado rate applies
Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.
- Acres Green
- Aetna Estates
- Aguilar
- Air Force Academy
- Akron
- Alamosa
- Alamosa East
- Allenspark
43499 billing questions
When should 43499 be used instead of a specific esophageal procedure code?
Use 43499 for an esophageal procedure that does not have a more specific CPT code. Listed codes for procedures such as dilation or transoral lower esophageal myotomy apply when the procedure performed matches.
How does Medicare price 43499?
Medicare physician fee schedule status C means there is no national payment; the Medicare Administrative Contractor sets payment for each claim.
Who sets the global period for 43499?
The Medicare contractor sets the global period.
How is 43499 treated when multiple procedures are performed in the same session?
The highest-valued procedure is paid in full and the others at 50% under the stated Medicare multiple procedure rule.
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
Fee sheets · Coming soon
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Your codes at your locality, with payer contracts beside Medicare.
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