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Billing code 43244: Variceal ligationMedicare rate & RVUs

Reports therapeutic upper endoscopy in which an endoscopist places bands on esophageal or gastric varices to treat or prevent variceal bleeding.

CMS RVU26DEffective Oct 1, 2026109 payment localities17.2K Medicare services in 2024

Medicare pays $215.44 for 43244 nationally in a facility.

Medicare rate · 43244

Variceal ligation

Swap in your local Medicare rate.

Work RVUs
4.29
Total RVUs
6.45
Global days
000

National rate · 2026

$215.44

Facility setting, before claim adjustments.

See every locality for 43244 → · 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 43244 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 43244 covers

During upper endoscopy, the gastroenterologist or other qualified endoscopist identifies varices and deploys bands to close them. The service is used for varices associated with portal hypertension, including varices treated because they are bleeding or to reduce bleeding risk. The treated sites may be in the esophagus, stomach, or both; documentation should identify the varices and describe the ligation performed.

Report this code for endoscopic band treatment, rather than injection therapy reported with 43243. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted for this code.

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 43244 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

43244 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$201.57
Alaska*Unavailable$283.70
ArizonaUnavailable$211.43
ArkansasUnavailable$199.86
AtlantaUnavailable$219.92
AustinUnavailable$217.21
BakersfieldUnavailable$217.44
Baltimore/Surr. CntysUnavailable$225.57
BeaumontUnavailable$209.24
BrazoriaUnavailable$212.62

43244 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
43244 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 43244 rate is calculated

Each of 43244’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 · 43244

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.29Practice expense 1.69Malpractice 0.47

6.4500 adjusted RVUs×$33.4009 conversion factor=$215.44

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

Payment rules and modifiers for 43244

The CMS indicators that decide how 43244 is paid alongside other services.

CMS payment indicators · 43244

Variceal ligation

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

43244 without 51 · national facility

$215.44

Variceal ligation

43244-51 · Second procedure: 50%

$107.72

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

43244 compared with similar codes

Compare codes

43244 vs 43243 vs 43255 vs 43235: national Medicare rates

Swap in your local Medicare rate.

  • 43244
    Variceal ligation · 4.29 wRVU
    —
  • 43243
    Variceal injection · 4.16 wRVU
    —
  • 43255
    Bleeding control · 3.47 wRVU
    $689.06
  • 43235
    Upper GI endoscopy · 2.04 wRVU
    $322.65

How to choose

43243Variceal injection
Both address varices, but 43244 is for band ligation and 43243 is for injection treatment.
43255Bleeding control
43244 identifies band ligation of varices; 43255 describes endoscopic control of bleeding by other methods.
43235Upper GI endoscopy
43235 is a diagnostic upper endoscopy with brushing or washing when performed. Choose 43244 when the endoscopist performs variceal band ligation.

Codes related to 43244

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

Codes related to 43244
CodeHow it relatesNational office range
Used instead
43243Variceal injectionVariceal injection therapy is reported instead when the documented treatment uses injection rather than band ligation.No office rate
43255Bleeding controlUsed for endoscopic bleeding control by methods other than variceal band ligation.$603.76–$943.34
43235Upper GI endoscopyFor diagnostic upper endoscopy with brushing or washing when variceal band treatment is not performed.$284.01–$435.38

43244 billing questions

How does this differ from 43243?

Use 43244 when varices are treated with endoscopic bands. Code 43243 describes injection treatment of varices.

Can 43244 be reported per band placed?

Report the endoscopic ligation service, not a separate unit for each band. Document the treated sites and the ligation performed.

When is 43255 a better fit?

Code 43255 is for endoscopic control of bleeding by methods other than variceal band ligation. Use 43244 when the documented treatment is banding varices.

Should modifier 50 be appended when varices are treated in both the esophagus and stomach?

No. Modifier 50 is inappropriate for this code; the service can involve esophageal varices, gastric varices, or both.

What same-day care is included?

The 0-day global period includes same-day preoperative and postoperative care. Related endoscopies performed together are subject to endoscopy family pricing.

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 43244PPRRVU2026_Oct_nonQPP.csv, line 5,172 (RVU26D)

Open CMS sourceHow we calculate rates

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