No office rate
Choose 43231 for esophageal EUS without needle sampling. Choose 43232 when the esophageal EUS includes transendoscopic fine needle aspiration or biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
43231 in Chico
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$138.93
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Gastroenterology endoscopy
About 43231: Esophageal endoscopic ultrasound examination
Reports transoral flexible esophagoscopy with endoscopic ultrasound confined to the esophagus, such as assessment of an esophageal lesion or wall thickening.
A gastroenterologist or other qualified physician passes a flexible endoscope through the mouth and uses ultrasound to examine structures in or adjacent to the esophagus. Typical uses include assessing an esophageal subepithelial lesion, wall thickening, or local tumor involvement. The ultrasound examination must be confined to the esophagus; this is not the code for an EUS-guided needle sample.
Select this service based on the documented scope and extent of the ultrasound examination, not simply the patient’s diagnosis. The report should identify the esophageal findings and support that EUS was performed. When related endoscopies are performed together, CMS endoscopy family pricing adjusts payment for the combined services. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate. CMS does not pay an assistant at surgery; co-surgeons are permitted, while team surgery is not.
CMS billing rules for 43231
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.73 · 66%
- Practice expense (office) RVU1.13 · 27%
- Malpractice RVU0.27 · 7%
541
Medicare services in 2024 · #3485 by national volume
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.
43231 compared with similar codes
Office rates for Chico, from the same CMS release.
No office rate
43231 is confined to esophagoscopy and esophageal EUS. 43237 describes an EGD-based EUS examination that may include the stomach or duodenum as appropriate.
No office rate
43238 is an EGD-based EUS service with guided needle sampling; 43231 is an examination-only esophageal EUS service.
The same code, a different location
How does Chico compare?
43231 across payment areas
Same release and payment basis · bars start at $0
Chico · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 43231
Office
Unavailable
Facility
$138.93
No comparable office rate is available.
Modesto
California · 43231
Office
Unavailable
Facility
$138.93
No comparable office rate is available.
Napa
California · 43231
Office
Unavailable
Facility
$151.26
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 43231
Office
Unavailable
Facility
$143.97
No comparable office rate is available.
Redding
California · 43231
Office
Unavailable
Facility
$138.93
No comparable office rate is available.
Rest Of California
California · 43231
Office
Unavailable
Facility
$138.93
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 43231
Office
Unavailable
Facility
$141.88
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 43231
Office
Unavailable
Facility
$143.20
No comparable office rate is available.
Salinas
California · 43231
Office
Unavailable
Facility
$142.59
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 43231
Office
Unavailable
Facility
$143.95
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 43231
Office
Unavailable
Facility
$157.20
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 43231
Office
Unavailable
Facility
$156.90
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 43231
Office
Unavailable
Facility
$160.47
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 43231
Office
Unavailable
Facility
$159.22
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 43231
Office
Unavailable
Facility
$140.56
No comparable office rate is available.
Santa Cruz-Watsonville
California · 43231
Office
Unavailable
Facility
$143.79
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 43231
Office
Unavailable
Facility
$142.58
No comparable office rate is available.
Santa Rosa-Petaluma
California · 43231
Office
Unavailable
Facility
$145.10
No comparable office rate is available.
Stockton
California · 43231
Office
Unavailable
Facility
$138.93
No comparable office rate is available.
Vallejo
California · 43231
Office
Unavailable
Facility
$150.81
No comparable office rate is available.
Visalia
California · 43231
Office
Unavailable
Facility
$138.93
No comparable office rate is available.
Yuba City
California · 43231
Office
Unavailable
Facility
$138.93
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 43231
Office
Unavailable
Facility
$150.61
No comparable office rate is available.
Miami
Florida · 43231
Office
Unavailable
Facility
$153.28
No comparable office rate is available.
Chicago
Illinois · 43231
Office
Unavailable
Facility
$150.45
No comparable office rate is available.
Manhattan
New York · 43231
Office
Unavailable
Facility
$155.18
No comparable office rate is available.
Alaska*
Alaska · 43231
Office
Unavailable
Facility
$181.94
No comparable office rate is available.
Alabama
Alabama · 43231
Office
Unavailable
Facility
$129.31
No comparable office rate is available.
Arkansas
Arkansas · 43231
Office
Unavailable
Facility
$128.25
No comparable office rate is available.
Arizona
Arizona · 43231
Office
Unavailable
Facility
$135.48
No comparable office rate is available.
Colorado
Colorado · 43231
Office
Unavailable
Facility
$139.48
No comparable office rate is available.
Connecticut
Connecticut · 43231
Office
Unavailable
Facility
$144.57
No comparable office rate is available.
Delaware
Delaware · 43231
Office
Unavailable
Facility
$137.04
No comparable office rate is available.
Fort Lauderdale
Florida · 43231
Office
Unavailable
Facility
$145.72
No comparable office rate is available.
Rest Of Florida
Florida · 43231
Office
Unavailable
Facility
$140.82
No comparable office rate is available.
Atlanta
Georgia · 43231
Office
Unavailable
Facility
$140.64
No comparable office rate is available.
Rest Of Georgia
Georgia · 43231
Office
Unavailable
Facility
$135.60
No comparable office rate is available.
Hawaii, Guam
Hawaii · 43231
Office
Unavailable
Facility
$139.32
No comparable office rate is available.
Iowa
Iowa · 43231
Office
Unavailable
Facility
$129.30
No comparable office rate is available.
Idaho
Idaho · 43231
Office
Unavailable
Facility
$130.17
No comparable office rate is available.
East St. Louis
Illinois · 43231
Office
Unavailable
Facility
$144.07
No comparable office rate is available.
Rest Of Illinois
Illinois · 43231
Office
Unavailable
Facility
$139.74
No comparable office rate is available.
Suburban Chicago
Illinois · 43231
Office
Unavailable
Facility
$146.57
No comparable office rate is available.
Indiana
Indiana · 43231
Office
Unavailable
Facility
$130.56
No comparable office rate is available.
Kansas
Kansas · 43231
Office
Unavailable
Facility
$129.85
No comparable office rate is available.
Kentucky
Kentucky · 43231
Office
Unavailable
Facility
$132.99
No comparable office rate is available.
New Orleans
Louisiana · 43231
Office
Unavailable
Facility
$136.95
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 43231
Office
Unavailable
Facility
$133.23
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 43231
Office
Unavailable
Facility
$148.01
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 43231
Office
Unavailable
Facility
$139.57
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 43231
Office
Unavailable
Facility
$144.30
No comparable office rate is available.
Rest Of Maryland
Maryland · 43231
Office
Unavailable
Facility
$138.57
No comparable office rate is available.
Rest Of Maine
Maine · 43231
Office
Unavailable
Facility
$131.52
No comparable office rate is available.
Southern Maine
Maine · 43231
Office
Unavailable
Facility
$134.28
No comparable office rate is available.
Detroit
Michigan · 43231
Office
Unavailable
Facility
$142.81
No comparable office rate is available.
Rest Of Michigan
Michigan · 43231
Office
Unavailable
Facility
$135.83
No comparable office rate is available.
Minnesota
Minnesota · 43231
Office
Unavailable
Facility
$132.69
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 43231
Office
Unavailable
Facility
$135.44
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 43231
Office
Unavailable
Facility
$136.15
No comparable office rate is available.
Rest Of Missouri
Missouri · 43231
Office
Unavailable
Facility
$132.50
No comparable office rate is available.
Mississippi
Mississippi · 43231
Office
Unavailable
Facility
$130.35
No comparable office rate is available.
Montana**
Montana · 43231
Office
Unavailable
Facility
$137.93
No comparable office rate is available.
North Carolina
North Carolina · 43231
Office
Unavailable
Facility
$132.16
No comparable office rate is available.
North Dakota**
North Dakota · 43231
Office
Unavailable
Facility
$132.59
No comparable office rate is available.
Nebraska
Nebraska · 43231
Office
Unavailable
Facility
$129.43
No comparable office rate is available.
New Hampshire
New Hampshire · 43231
Office
Unavailable
Facility
$138.37
No comparable office rate is available.
Northern Nj
New Jersey · 43231
Office
Unavailable
Facility
$150.34
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 43231
Office
Unavailable
Facility
$145.94
No comparable office rate is available.
New Mexico
New Mexico · 43231
Office
Unavailable
Facility
$136.63
No comparable office rate is available.
Nevada**
Nevada · 43231
Office
Unavailable
Facility
$136.48
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 43231
Office
Unavailable
Facility
$158.64
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 43231
Office
Unavailable
Facility
$147.53
No comparable office rate is available.
Queens
New York · 43231
Office
Unavailable
Facility
$154.64
No comparable office rate is available.
Rest Of New York
New York · 43231
Office
Unavailable
Facility
$133.38
No comparable office rate is available.
Ohio
Ohio · 43231
Office
Unavailable
Facility
$134.73
No comparable office rate is available.
Oklahoma
Oklahoma · 43231
Office
Unavailable
Facility
$131.90
No comparable office rate is available.
Portland
Oregon · 43231
Office
Unavailable
Facility
$141.29
No comparable office rate is available.
Rest Of Oregon
Oregon · 43231
Office
Unavailable
Facility
$135.12
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 43231
Office
Unavailable
Facility
$142.88
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 43231
Office
Unavailable
Facility
$134.35
No comparable office rate is available.
Puerto Rico
Puerto Rico · 43231
Office
Unavailable
Facility
$138.23
No comparable office rate is available.
Rhode Island
Rhode Island · 43231
Office
Unavailable
Facility
$139.95
No comparable office rate is available.
South Carolina
South Carolina · 43231
Office
Unavailable
Facility
$133.72
No comparable office rate is available.
South Dakota**
South Dakota · 43231
Office
Unavailable
Facility
$131.96
No comparable office rate is available.
Tennessee
Tennessee · 43231
Office
Unavailable
Facility
$130.34
No comparable office rate is available.
Austin
Texas · 43231
Office
Unavailable
Facility
$139.29
No comparable office rate is available.
Beaumont
Texas · 43231
Office
Unavailable
Facility
$133.91
No comparable office rate is available.
Brazoria
Texas · 43231
Office
Unavailable
Facility
$136.35
No comparable office rate is available.
Dallas
Texas · 43231
Office
Unavailable
Facility
$137.33
No comparable office rate is available.
Fort Worth
Texas · 43231
Office
Unavailable
Facility
$137.07
No comparable office rate is available.
Galveston
Texas · 43231
Office
Unavailable
Facility
$136.86
No comparable office rate is available.
Houston
Texas · 43231
Office
Unavailable
Facility
$141.80
No comparable office rate is available.
Rest Of Texas
Texas · 43231
Office
Unavailable
Facility
$135.15
No comparable office rate is available.
Utah
Utah · 43231
Office
Unavailable
Facility
$134.76
No comparable office rate is available.
Virginia
Virginia · 43231
Office
Unavailable
Facility
$134.65
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 43231
Office
Unavailable
Facility
$138.23
No comparable office rate is available.
Vermont
Vermont · 43231
Office
Unavailable
Facility
$133.11
No comparable office rate is available.
Rest Of Washington
Washington · 43231
Office
Unavailable
Facility
$138.98
No comparable office rate is available.
Seattle (King Cnty)
Washington · 43231
Office
Unavailable
Facility
$149.42
No comparable office rate is available.
Wisconsin
Wisconsin · 43231
Office
Unavailable
Facility
$130.12
No comparable office rate is available.
West Virginia
West Virginia · 43231
Office
Unavailable
Facility
$136.89
No comparable office rate is available.
Wyoming**
Wyoming · 43231
Office
Unavailable
Facility
$135.60
No comparable office rate is available.
See how rates vary across the country
43231 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Where does this rate apply?
Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 43231 in Chico. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$152.82
$138.93 × 110% = $152.82
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 43231 in Chico.
PPRRVU2026_Oct_nonQPP.csv
5,160
- Code
- 43231
- Physician work
- 2.73
- Practice expense
- 1.13
- Malpractice
- 0.27
GPCI2026.csv
9
- Locality
- Chico
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.73 | × 1.017 | 2.7764 |
| Practice expense | 1.13 | × 1.096 | 1.2385 |
| Malpractice | 0.27 | × 0.536 | 0.1447 |
| Total RVUs | 4.1596 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Chico$138.93
Open 43231 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.73 | 1.017 |
| Practice expense | 1.13 | 1.096 |
| Malpractice | 0.27 | 0.536 |
(2.73 × 1.017 + 1.13 × 1.096 + 0.27 × 0.536) × $33.4009 = $138.93
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
43231 · 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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $138.93 | RVU26D |
| 2026-07-01 | Not available in this setting | $138.93 | RVU26C |
| 2026-04-01 | Not available in this setting | $138.93 | RVU26B |
| 2026-01-01 | Not available in this setting | $138.93 | RVU26A |
| 2025-10-01 | Not available in this setting | $150.83 | RVU25D |
| 2025-07-01 | Not available in this setting | $150.83 | RVU25C |
| 2025-04-01 | Not available in this setting | $150.83 | RVU25B |
| 2025-01-01 | Not available in this setting | $150.83 | RVU25A |
43231 billing questions
When should 43231 be chosen over 43237?
Use 43231 when flexible esophagoscopy with EUS is confined to the esophagus. Use 43237 for an EGD-based EUS examination that includes the stomach or duodenum as appropriate.
How does 43231 differ from 43232?
43231 describes an esophageal EUS examination without needle sampling. 43232 is for esophageal EUS-guided fine needle aspiration or biopsy.
Can EUS-guided needle sampling be reported with 43231?
When EUS-guided sampling is performed, consider the sampling code that matches the scope and anatomic extent, such as 43232 for esophageal esophagoscopy. The documentation should show the sampling service performed.
How are related endoscopies paid when performed together?
CMS endoscopy family pricing adjusts payment when related endoscopies are performed in the same session. Report the services supported by the procedure documentation.
Does 43231 have a global period or bilateral adjustment?
It has a 0-day global period, with same-day preoperative and postoperative care included. Modifier 50 is inappropriate for this service.
Can an assistant or additional surgeons be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons are permitted, but team surgery is not.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,15743227,,Esophagoscopy control bleed,A,,2.82,16.44,,1.22,,0.36,19.62,4.40,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43200,33.4009,09,0,99,0.00,0.00,0.00
5,15843229,,Esophagoscopy lesion ablate,A,,3.40,19.60,,1.42,,0.41,23.41,5.23,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43200,33.4009,09,0,99,0.00,0.00,0.00
5,1594322F,,Crgvr prov w/ ed addl rsrcs,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,16043231,,Esophagoscop ultrasound exam,A,,2.73,1.13,NA,1.13,,0.27,4.13,4.13,0,000,0.00,0.00,0.00,3,0,1,2,0,9,43200,33.4009,09,0,99,0.00,0.00,0.00
5,16143232,,Esophagoscopy w/us needle bx,A,,3.50,1.42,NA,1.42,,0.39,5.31,5.31,0,000,0.00,0.00,0.00,3,0,1,2,0,9,43200,33.4009,09,0,99,0.00,0.00,0.00
5,16243233,,Egd balloon dil esoph30 mm/>,A,,3.97,1.52,NA,1.52,,0.62,6.11,6.11,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43235,33.4009,09,0,99,0.00,0.00,0.00
5,16343235,,Egd diagnostic brush wash,A,,2.04,7.38,,1.03,,0.24,9.66,3.31,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536