$1,166.81
Both describe esophageal balloon dilation during upper endoscopy. The balloon size distinguishes them: 43233 is for 30 mm or larger, while 43249 is for less than 30 mm.
On this page
CMS RVU26D · Effective 2026-10-01
43233 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$202.04
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.
Gastrointestinal endoscopy
About 43233: Upper endoscopy with large-balloon esophageal dilation
Reports upper endoscopy with balloon dilation of an esophageal narrowing using a balloon 30 mm or larger, including pneumatic dilation for achalasia.
A gastroenterologist or other qualified physician passes an upper endoscope through the mouth to examine the esophagus and perform balloon dilation with a balloon measuring 30 mm or larger. The service may be used for an esophageal narrowing or for pneumatic dilation in achalasia. It is commonly performed in a hospital endoscopy unit or ambulatory surgery center; office use is less common.
Choose this code based on the esophageal treatment and balloon diameter, not simply because an upper endoscopy was performed. The report should identify the esophageal indication and treatment site, document balloon size and dilation, and describe the findings and response. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 43233
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.97 · 65%
- Practice expense (office) RVU1.52 · 25%
- Malpractice RVU0.62 · 10%
1.3K
Medicare services in 2024 · #2799 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.
43233 compared with similar codes
Office rates for Delaware, from the same CMS release.
$453.03
43233 describes large-balloon dilation. Choose 43248 when the esophagus is dilated over a guidewire instead.
$647.59
43233 treats an esophageal narrowing with a large balloon; 43245 describes dilation of the gastric outlet.
The same code, a different location
How does Delaware compare?
43233 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
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.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Delaware 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
Alabama
Alabama · 43233
Office
Unavailable
Facility
$188.75
No comparable office rate is available.
Arkansas
Arkansas · 43233
Office
Unavailable
Facility
$186.88
No comparable office rate is available.
Arizona
Arizona · 43233
Office
Unavailable
Facility
$199.52
No comparable office rate is available.
Bakersfield
California · 43233
Office
Unavailable
Facility
$203.38
No comparable office rate is available.
Chico
California · 43233
Office
Unavailable
Facility
$201.60
No comparable office rate is available.
El Centro
California · 43233
Office
Unavailable
Facility
$201.70
No comparable office rate is available.
Fresno
California · 43233
Office
Unavailable
Facility
$201.60
No comparable office rate is available.
Hanford-Corcoran
California · 43233
Office
Unavailable
Facility
$201.60
No comparable office rate is available.
Madera
California · 43233
Office
Unavailable
Facility
$201.60
No comparable office rate is available.
Merced
California · 43233
Office
Unavailable
Facility
$201.60
No comparable office rate is available.
Modesto
California · 43233
Office
Unavailable
Facility
$201.60
No comparable office rate is available.
Napa
California · 43233
Office
Unavailable
Facility
$218.39
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 43233
Office
Unavailable
Facility
$209.23
No comparable office rate is available.
Redding
California · 43233
Office
Unavailable
Facility
$201.60
No comparable office rate is available.
Rest Of California
California · 43233
Office
Unavailable
Facility
$201.60
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 43233
Office
Unavailable
Facility
$208.30
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 43233
Office
Unavailable
Facility
$207.52
No comparable office rate is available.
Salinas
California · 43233
Office
Unavailable
Facility
$206.65
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 43233
Office
Unavailable
Facility
$208.52
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 43233
Office
Unavailable
Facility
$226.29
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 43233
Office
Unavailable
Facility
$225.58
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 43233
Office
Unavailable
Facility
$231.50
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 43233
Office
Unavailable
Facility
$228.62
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 43233
Office
Unavailable
Facility
$203.78
No comparable office rate is available.
Santa Cruz-Watsonville
California · 43233
Office
Unavailable
Facility
$208.17
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 43233
Office
Unavailable
Facility
$206.61
No comparable office rate is available.
Santa Rosa-Petaluma
California · 43233
Office
Unavailable
Facility
$210.02
No comparable office rate is available.
Stockton
California · 43233
Office
Unavailable
Facility
$201.60
No comparable office rate is available.
Vallejo
California · 43233
Office
Unavailable
Facility
$217.37
No comparable office rate is available.
Visalia
California · 43233
Office
Unavailable
Facility
$201.60
No comparable office rate is available.
Yuba City
California · 43233
Office
Unavailable
Facility
$201.60
No comparable office rate is available.
Colorado
Colorado · 43233
Office
Unavailable
Facility
$204.38
No comparable office rate is available.
Connecticut
Connecticut · 43233
Office
Unavailable
Facility
$214.99
No comparable office rate is available.
Fort Lauderdale
Florida · 43233
Office
Unavailable
Facility
$221.47
No comparable office rate is available.
Rest Of Florida
Florida · 43233
Office
Unavailable
Facility
$212.26
No comparable office rate is available.
Atlanta
Georgia · 43233
Office
Unavailable
Facility
$209.45
No comparable office rate is available.
Rest Of Georgia
Georgia · 43233
Office
Unavailable
Facility
$202.57
No comparable office rate is available.
Hawaii, Guam
Hawaii · 43233
Office
Unavailable
Facility
$202.32
No comparable office rate is available.
Iowa
Iowa · 43233
Office
Unavailable
Facility
$187.28
No comparable office rate is available.
Idaho
Idaho · 43233
Office
Unavailable
Facility
$189.10
No comparable office rate is available.
East St. Louis
Illinois · 43233
Office
Unavailable
Facility
$221.02
No comparable office rate is available.
Rest Of Illinois
Illinois · 43233
Office
Unavailable
Facility
$211.32
No comparable office rate is available.
Suburban Chicago
Illinois · 43233
Office
Unavailable
Facility
$222.37
No comparable office rate is available.
Indiana
Indiana · 43233
Office
Unavailable
Facility
$189.73
No comparable office rate is available.
Kansas
Kansas · 43233
Office
Unavailable
Facility
$188.93
No comparable office rate is available.
Kentucky
Kentucky · 43233
Office
Unavailable
Facility
$196.68
No comparable office rate is available.
New Orleans
Louisiana · 43233
Office
Unavailable
Facility
$203.90
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 43233
Office
Unavailable
Facility
$197.37
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 43233
Office
Unavailable
Facility
$217.09
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 43233
Office
Unavailable
Facility
$204.69
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 43233
Office
Unavailable
Facility
$214.82
No comparable office rate is available.
Rest Of Maryland
Maryland · 43233
Office
Unavailable
Facility
$204.32
No comparable office rate is available.
Rest Of Maine
Maine · 43233
Office
Unavailable
Facility
$192.19
No comparable office rate is available.
Southern Maine
Maine · 43233
Office
Unavailable
Facility
$195.98
No comparable office rate is available.
Detroit
Michigan · 43233
Office
Unavailable
Facility
$216.51
No comparable office rate is available.
Rest Of Michigan
Michigan · 43233
Office
Unavailable
Facility
$202.33
No comparable office rate is available.
Minnesota
Minnesota · 43233
Office
Unavailable
Facility
$190.97
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 43233
Office
Unavailable
Facility
$200.51
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 43233
Office
Unavailable
Facility
$201.68
No comparable office rate is available.
Rest Of Missouri
Missouri · 43233
Office
Unavailable
Facility
$196.53
No comparable office rate is available.
Mississippi
Mississippi · 43233
Office
Unavailable
Facility
$191.62
No comparable office rate is available.
Montana**
Montana · 43233
Office
Unavailable
Facility
$204.04
No comparable office rate is available.
North Carolina
North Carolina · 43233
Office
Unavailable
Facility
$193.20
No comparable office rate is available.
North Dakota**
North Dakota · 43233
Office
Unavailable
Facility
$191.78
No comparable office rate is available.
Nebraska
Nebraska · 43233
Office
Unavailable
Facility
$187.29
No comparable office rate is available.
New Hampshire
New Hampshire · 43233
Office
Unavailable
Facility
$203.57
No comparable office rate is available.
Northern Nj
New Jersey · 43233
Office
Unavailable
Facility
$221.96
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 43233
Office
Unavailable
Facility
$216.06
No comparable office rate is available.
New Mexico
New Mexico · 43233
Office
Unavailable
Facility
$204.03
No comparable office rate is available.
Nevada**
Nevada · 43233
Office
Unavailable
Facility
$200.67
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 43233
Office
Unavailable
Facility
$239.91
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 43233
Office
Unavailable
Facility
$219.22
No comparable office rate is available.
Queens
New York · 43233
Office
Unavailable
Facility
$230.96
No comparable office rate is available.
Rest Of New York
New York · 43233
Office
Unavailable
Facility
$195.39
No comparable office rate is available.
Ohio
Ohio · 43233
Office
Unavailable
Facility
$199.83
No comparable office rate is available.
Oklahoma
Oklahoma · 43233
Office
Unavailable
Facility
$194.03
No comparable office rate is available.
Portland
Oregon · 43233
Office
Unavailable
Facility
$206.54
No comparable office rate is available.
Rest Of Oregon
Oregon · 43233
Office
Unavailable
Facility
$197.73
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 43233
Office
Unavailable
Facility
$212.54
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 43233
Office
Unavailable
Facility
$198.78
No comparable office rate is available.
Puerto Rico
Puerto Rico · 43233
Office
Unavailable
Facility
$204.33
No comparable office rate is available.
Rhode Island
Rhode Island · 43233
Office
Unavailable
Facility
$206.04
No comparable office rate is available.
South Carolina
South Carolina · 43233
Office
Unavailable
Facility
$197.11
No comparable office rate is available.
South Dakota**
South Dakota · 43233
Office
Unavailable
Facility
$190.33
No comparable office rate is available.
Tennessee
Tennessee · 43233
Office
Unavailable
Facility
$189.87
No comparable office rate is available.
Austin
Texas · 43233
Office
Unavailable
Facility
$204.93
No comparable office rate is available.
Beaumont
Texas · 43233
Office
Unavailable
Facility
$198.04
No comparable office rate is available.
Brazoria
Texas · 43233
Office
Unavailable
Facility
$200.13
No comparable office rate is available.
Dallas
Texas · 43233
Office
Unavailable
Facility
$202.13
No comparable office rate is available.
Fort Worth
Texas · 43233
Office
Unavailable
Facility
$201.89
No comparable office rate is available.
Galveston
Texas · 43233
Office
Unavailable
Facility
$201.22
No comparable office rate is available.
Houston
Texas · 43233
Office
Unavailable
Facility
$212.57
No comparable office rate is available.
Rest Of Texas
Texas · 43233
Office
Unavailable
Facility
$199.48
No comparable office rate is available.
Utah
Utah · 43233
Office
Unavailable
Facility
$198.92
No comparable office rate is available.
Virginia
Virginia · 43233
Office
Unavailable
Facility
$197.13
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 43233
Office
Unavailable
Facility
$204.33
No comparable office rate is available.
Vermont
Vermont · 43233
Office
Unavailable
Facility
$193.34
No comparable office rate is available.
Rest Of Washington
Washington · 43233
Office
Unavailable
Facility
$203.54
No comparable office rate is available.
Seattle (King Cnty)
Washington · 43233
Office
Unavailable
Facility
$218.44
No comparable office rate is available.
Wisconsin
Wisconsin · 43233
Office
Unavailable
Facility
$187.62
No comparable office rate is available.
West Virginia
West Virginia · 43233
Office
Unavailable
Facility
$206.35
No comparable office rate is available.
Wyoming**
Wyoming · 43233
Office
Unavailable
Facility
$198.70
No comparable office rate is available.
See how rates vary across the country
43233 · 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?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, 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 43233 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$222.24
$202.04 × 110% = $222.24
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 43233 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
5,162
- Code
- 43233
- Physician work
- 3.97
- Practice expense
- 1.52
- Malpractice
- 0.62
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.97 | × 1.005 | 3.9898 |
| Practice expense | 1.52 | × 0.988 | 1.5018 |
| Malpractice | 0.62 | × 0.899 | 0.5574 |
| Total RVUs | 6.0490 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$202.04
Open 43233 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.97 | 1.005 |
| Practice expense | 1.52 | 0.988 |
| Malpractice | 0.62 | 0.899 |
(3.97 × 1.005 + 1.52 × 0.988 + 0.62 × 0.899) × $33.4009 = $202.04
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
43233 · 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 | $202.04 | RVU26D |
| 2026-07-01 | Not available in this setting | $202.04 | RVU26C |
| 2026-04-01 | Not available in this setting | $202.04 | RVU26B |
| 2026-01-01 | Not available in this setting | $202.04 | RVU26A |
| 2025-10-01 | Not available in this setting | $219.22 | RVU25D |
| 2025-07-01 | Not available in this setting | $219.22 | RVU25C |
| 2025-04-01 | Not available in this setting | $219.22 | RVU25B |
| 2025-01-01 | Not available in this setting | $219.22 | RVU25A |
43233 billing questions
When should 43233 be chosen instead of 43249?
Use 43233 for esophageal balloon dilation with a balloon 30 mm or larger. Code 43249 describes esophageal balloon dilation with a balloon smaller than 30 mm.
How does 43233 differ from guidewire dilation?
43233 describes balloon dilation using a balloon at least 30 mm in diameter. Code 43248 is used for esophageal dilation over a guidewire rather than this large-balloon service.
Can the diagnostic upper endoscopy be reported separately?
Do not report a separate diagnostic EGD code just for inspection performed as part of the dilation. When related endoscopies are performed together, Medicare applies endoscopy family pricing.
Is modifier 50 appropriate for this code?
No. The anatomy and service descriptor make bilateral reporting with modifier 50 inappropriate.
What should the procedure note document?
Document the esophageal indication and treatment site, the balloon diameter used, the dilation performed, and relevant findings and response. The balloon must measure 30 mm or larger for this code.
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.
5,1594322F,,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
5,16443236,,Uppr gi scope w/submuc inj,A,,2.33,10.76,,1.10,,0.27,13.36,3.70,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43235,33.4009,09,0,99,0.00,0.00,0.00
5,16543237,,Endoscopic us exam esoph,A,,3.38,1.42,NA,1.42,,0.38,5.18,5.18,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43235,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503