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Billing code 43241: Endoscopic tube placementMedicare rate & RVUs

Report this service when an upper endoscopy is used to place an intraluminal tube or catheter, such as a nasoenteric feeding tube.

CMS RVU26DEffective Oct 1, 2026109 payment localities4.2K Medicare services in 2024

Medicare pays $126.92 for 43241 nationally in a facility.

Medicare rate · 43241

Endoscopic tube placement

Swap in your local Medicare rate.

Work RVUs
2.43
Total RVUs
3.80
Global days
000

National rate · 2026

$126.92

Facility setting, before claim adjustments.

See every locality for 43241 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 43241 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 43241 covers

A gastroenterologist or other qualified endoscopist advances a flexible scope through the mouth to guide an intraluminal tube or catheter into the upper gastrointestinal tract. A common use is placing a nasoenteric feeding tube under direct visualization, including when blind advancement is unsuccessful or tube position needs endoscopic guidance. The procedure may be performed in a hospital or, less commonly, an office setting.

Choose this code when tube or catheter insertion is the therapeutic service, rather than simply inspecting the esophagus, stomach, and duodenum. The report should identify the indication, the tube or catheter placed, and the endoscopic guidance and placement performed. This is a minor procedure with 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; Medicare does not pay an assistant at surgery, 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.

Where 43241 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

43241 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$118.11
Alaska*Unavailable$165.33
ArizonaUnavailable$124.37
ArkansasUnavailable$117.02
AtlantaUnavailable$129.75
AustinUnavailable$128.02
BakersfieldUnavailable$127.98
Baltimore/Surr. CntysUnavailable$133.21
BeaumontUnavailable$123.00
BrazoriaUnavailable$125.05

43241 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
43241 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 43241 rate is calculated

Each of 43241’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 · 43241

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 2.43Practice expense 1.07Malpractice 0.30

3.8000 adjusted RVUs×$33.4009 conversion factor=$126.92

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 43241

The CMS indicators that decide how 43241 is paid alongside other services.

CMS payment indicators · 43241

Endoscopic tube placement

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

43241 without 51 · national facility

$126.92

Endoscopic tube placement

43241-51 · Second procedure: 50%

$63.46

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

43241 compared with similar codes

Compare codes

43241 vs 43246 vs 43248 vs 43235 vs 43239: national Medicare rates

Swap in your local Medicare rate.

  • 43241
    Endoscopic tube placement · 2.43 wRVU
    —
  • 43246
    PEG placement · 3.47 wRVU
    —
  • 43248
    Esophageal dilation · 2.84 wRVU
    $457.93
  • 43235
    Upper GI endoscopy · 2.04 wRVU
    $322.65
  • 43239
    EGD with biopsy · 2.33 wRVU
    $418.85

How to choose

43246PEG placement
Use 43241 for an intraluminal tube or catheter placed through the upper GI tract. Use 43246 when the endoscopist creates a gastrostomy and places a tube through the abdominal wall.
43248Esophageal dilation
43241 captures tube or catheter placement. 43248 is for guidewire-assisted esophageal dilation, not simply advancing a tube under endoscopic guidance.
43235Upper GI endoscopy
43235 describes diagnostic upper endoscopy without the tube-placement service. When the endoscopy guides tube insertion, report the therapeutic service rather than separately reporting the diagnostic examination.
43239EGD with biopsy
43239 is for mucosal biopsy during EGD. Use 43241 when the service performed is placement of an intraluminal tube or catheter; document any separately performed biopsy.

Codes related to 43241

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

Codes related to 43241
CodeHow it relatesNational office range
Used instead
43246PEG placementFor endoscopic gastrostomy-tube placement when enteral access is created through the abdominal wall.No office rate
Often billed with
43239EGD with biopsyMay be reported for a separately performed gastric or duodenal biopsy during the same EGD when supported.$367.66–$569.97
43248Esophageal dilationMay accompany tube placement when esophageal narrowing also requires guidewire-assisted dilation in the same session.$402.83–$618.55

43241 billing questions

How is this different from gastrostomy tube placement?

This code covers endoscopic placement of an intraluminal tube or catheter through the upper gastrointestinal tract. Code 43246 describes endoscopic placement of a gastrostomy tube through the abdominal wall.

Can a diagnostic EGD also be reported?

The inspection performed as part of the tube-placement procedure is integral to that service. Do not separately report a diagnostic EGD code for the same examination.

What documentation supports reporting this code?

Document the clinical reason for placement, the type of tube or catheter, and how endoscopy was used to guide its placement. The record should distinguish tube placement from diagnostic examination alone.

Should modifier 50 be used for placement on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

Can an assistant or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing are not permitted.

What happens when another related endoscopy is performed in the same session?

CMS endoscopy-family pricing applies when related endoscopies are performed together. Report the procedures supported by the operative note, with the applicable family pricing reflected in payment.

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 43241PPRRVU2026_Oct_nonQPP.csv, line 5,169 (RVU26D)

Open CMS sourceHow we calculate rates

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