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CMS RVU26D · Effective 2026-10-01

43229 in El Centro

Office / nonfacility

$840.41

Base rate per service

Facility setting

$174.88

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

About 43229: Flexible esophagoscopy with lesion ablation

Reports flexible transoral esophagoscopy with energy-based treatment of an esophageal lesion, such as dysplastic Barrett’s tissue, rather than lesion excision.

A gastroenterologist or other qualified endoscopist advances a flexible scope through the mouth to visualize and ablate targeted esophageal tissue. A typical setting is endoscopic treatment of Barrett’s esophagus with dysplasia; the treatment destroys the target tissue rather than removing it with forceps or a snare. The service is distinct from diagnostic inspection, biopsy, and endoscopic removal of a lesion.

Report the code when the documented service includes esophageal lesion ablation, not merely examination or tissue sampling. The procedure note should identify the treated esophageal site and lesion, the ablation performed, and the clinical indication. CMS 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 for this descriptor and anatomy. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

CMS billing rules for 43229

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 RVU3.40 · 15%
  • Practice expense (office) RVU19.60 · 84%
  • Malpractice RVU0.41 · 2%

1.3K

Medicare services in 2024 · #2757 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.

43229 compared with similar codes

Office rates for El Centro, from the same CMS release.

43216

Esophageal lesion removal

Hot forceps or bipolar cautery

$487.87

Choose 43216 when the esophageal lesion is removed with forceps or cautery. This code represents ablation rather than lesion extraction.

43217

Esophageal lesion removal

Snare technique

$500.10

Choose 43217 for esophageal lesion removal by snare. Use this code when the treatment destroys the target tissue by ablation instead.

43235

Upper GI endoscopy

Diagnostic, brushings or washings

$343.80

43235 is for diagnostic upper endoscopy without the lesion-ablation service. It does not describe therapeutic destruction of esophageal tissue.

The same code, a different location

How does El Centro compare?

In Bakersfield, the office rate for 43229 is $841.57—$1.16 higher than the $840.41 rate in El Centro. Both use the same code, release and participation basis.

43229 across payment areas

Same release and payment basis · bars start at $0

  1. El Centro · This locality

    $840.41

  2. $1.16 higher than El Centro

  3. Chico

    $840.34

    $0.07 lower than El Centro

  4. Fresno

    $840.34

    $0.07 lower than El Centro

  5. $0.07 lower than El Centro

  6. $61.36 higher than El Centro

  7. Madera

    $840.34

    $0.07 lower than El Centro

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 43229 ranges from $682.97 in Arkansas to $1077.41 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

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 · 43229

    Office

    $840.34

    Facility

    $174.82

    $0.07 lower than El Centro for the office setting.

  • Modesto

    California · 43229

    Office

    $840.34

    Facility

    $174.82

    $0.07 lower than El Centro for the office setting.

  • Napa

    California · 43229

    Office

    $990.51

    Facility

    $190.19

    $150.10 higher than El Centro for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 43229

    Office

    $899.08

    Facility

    $181.34

    $58.67 higher than El Centro for the office setting.

  • Redding

    California · 43229

    Office

    $840.34

    Facility

    $174.82

    $0.07 lower than El Centro for the office setting.

  • Rest Of California

    California · 43229

    Office

    $840.34

    Facility

    $174.82

    $0.07 lower than El Centro for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 43229

    Office

    $844.79

    Facility

    $179.27

    $4.38 higher than El Centro for the office setting.

  • Sacramento-Roseville-Folsom

    California · 43229

    Office

    $886.36

    Facility

    $180.15

    $45.95 higher than El Centro for the office setting.

  • Salinas

    California · 43229

    Office

    $883.17

    Facility

    $179.39

    $42.76 higher than El Centro for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 43229

    Office

    $907.36

    Facility

    $181.12

    $66.95 higher than El Centro for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 43229

    Office

    $1053.70

    Facility

    $197.51

    $213.29 higher than El Centro for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 43229

    Office

    $1053.24

    Facility

    $197.05

    $212.83 higher than El Centro for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 43229

    Office

    $1077.41

    Facility

    $201.79

    $237.00 higher than El Centro for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 43229

    Office

    $1075.51

    Facility

    $199.88

    $235.10 higher than El Centro for the office setting.

  • San Luis Obispo-Paso Robles

    California · 43229

    Office

    $868.49

    Facility

    $176.86

    $28.08 higher than El Centro for the office setting.

  • Santa Cruz-Watsonville

    California · 43229

    Office

    $918.70

    Facility

    $180.91

    $78.29 higher than El Centro for the office setting.

  • Santa Maria-Santa Barbara

    California · 43229

    Office

    $887.41

    Facility

    $179.39

    $47.00 higher than El Centro for the office setting.

  • Santa Rosa-Petaluma

    California · 43229

    Office

    $928.23

    Facility

    $182.55

    $87.82 higher than El Centro for the office setting.

  • Stockton

    California · 43229

    Office

    $840.34

    Facility

    $174.82

    $0.07 lower than El Centro for the office setting.

  • Vallejo

    California · 43229

    Office

    $989.84

    Facility

    $189.52

    $149.43 higher than El Centro for the office setting.

  • Visalia

    California · 43229

    Office

    $840.34

    Facility

    $174.82

    $0.07 lower than El Centro for the office setting.

  • Yuba City

    California · 43229

    Office

    $840.34

    Facility

    $174.82

    $0.07 lower than El Centro for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 43229

    Office

    $906.12

    Facility

    $190.81

    $65.71 higher than El Centro for the office setting.

  • Miami

    Florida · 43229

    Office

    $829.69

    Facility

    $197.57

    $10.72 lower than El Centro for the office setting.

  • Chicago

    Illinois · 43229

    Office

    $803.72

    Facility

    $193.45

    $36.69 lower than El Centro for the office setting.

  • Manhattan

    New York · 43229

    Office

    $903.26

    Facility

    $197.66

    $62.85 higher than El Centro for the office setting.

  • Alaska*

    Alaska · 43229

    Office

    $875.10

    Facility

    $228.40

    $34.69 higher than El Centro for the office setting.

  • Alabama

    Alabama · 43229

    Office

    $694.14

    Facility

    $162.81

    $146.27 lower than El Centro for the office setting.

  • Arkansas

    Arkansas · 43229

    Office

    $682.97

    Facility

    $161.36

    $157.44 lower than El Centro for the office setting.

  • Arizona

    Arizona · 43229

    Office

    $759.65

    Facility

    $171.24

    $80.76 lower than El Centro for the office setting.

  • Colorado

    Colorado · 43229

    Office

    $822.18

    Facility

    $176.09

    $18.23 lower than El Centro for the office setting.

  • Connecticut

    Connecticut · 43229

    Office

    $837.47

    Facility

    $183.49

    $2.94 lower than El Centro for the office setting.

  • Delaware

    Delaware · 43229

    Office

    $773.24

    Facility

    $173.30

    $67.17 lower than El Centro for the office setting.

  • Fort Lauderdale

    Florida · 43229

    Office

    $801.49

    Facility

    $186.37

    $38.92 lower than El Centro for the office setting.

  • Rest Of Florida

    Florida · 43229

    Office

    $760.00

    Facility

    $179.49

    $80.41 lower than El Centro for the office setting.

  • Atlanta

    Georgia · 43229

    Office

    $795.48

    Facility

    $178.54

    $44.93 lower than El Centro for the office setting.

  • Rest Of Georgia

    Georgia · 43229

    Office

    $713.84

    Facility

    $172.19

    $126.57 lower than El Centro for the office setting.

  • Hawaii, Guam

    Hawaii · 43229

    Office

    $865.84

    Facility

    $175.42

    $25.43 higher than El Centro for the office setting.

  • Iowa

    Iowa · 43229

    Office

    $718.01

    Facility

    $162.40

    $122.40 lower than El Centro for the office setting.

  • Idaho

    Idaho · 43229

    Office

    $722.33

    Facility

    $163.68

    $118.08 lower than El Centro for the office setting.

  • East St. Louis

    Illinois · 43229

    Office

    $743.43

    Facility

    $184.78

    $96.98 lower than El Centro for the office setting.

  • Rest Of Illinois

    Illinois · 43229

    Office

    $732.67

    Facility

    $178.27

    $107.74 lower than El Centro for the office setting.

  • Suburban Chicago

    Illinois · 43229

    Office

    $810.96

    Facility

    $187.33

    $29.45 lower than El Centro for the office setting.

  • Indiana

    Indiana · 43229

    Office

    $727.09

    Facility

    $164.19

    $113.32 lower than El Centro for the office setting.

  • Kansas

    Kansas · 43229

    Office

    $712.28

    Facility

    $163.34

    $128.13 lower than El Centro for the office setting.

  • Kentucky

    Kentucky · 43229

    Office

    $708.08

    Facility

    $168.26

    $132.33 lower than El Centro for the office setting.

  • New Orleans

    Louisiana · 43229

    Office

    $745.15

    Facility

    $173.75

    $95.26 lower than El Centro for the office setting.

  • Rest Of Louisiana

    Louisiana · 43229

    Office

    $706.05

    Facility

    $168.66

    $134.36 lower than El Centro for the office setting.

  • Metropolitan Boston

    Massachusetts · 43229

    Office

    $912.07

    Facility

    $187.04

    $71.66 higher than El Centro for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 43229

    Office

    $815.65

    Facility

    $176.24

    $24.76 lower than El Centro for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 43229

    Office

    $834.77

    Facility

    $183.21

    $5.64 lower than El Centro for the office setting.

  • Rest Of Maryland

    Maryland · 43229

    Office

    $789.78

    Facility

    $175.27

    $50.63 lower than El Centro for the office setting.

  • Rest Of Maine

    Maine · 43229

    Office

    $724.37

    Facility

    $165.72

    $116.04 lower than El Centro for the office setting.

  • Southern Maine

    Maine · 43229

    Office

    $770.97

    Facility

    $169.21

    $69.44 lower than El Centro for the office setting.

  • Detroit

    Michigan · 43229

    Office

    $768.40

    Facility

    $182.42

    $72.01 lower than El Centro for the office setting.

  • Rest Of Michigan

    Michigan · 43229

    Office

    $726.73

    Facility

    $172.33

    $113.68 lower than El Centro for the office setting.

  • Minnesota

    Minnesota · 43229

    Office

    $791.26

    Facility

    $166.42

    $49.15 lower than El Centro for the office setting.

  • Metropolitan Kansas City

    Missouri · 43229

    Office

    $741.67

    Facility

    $171.48

    $98.74 lower than El Centro for the office setting.

  • Metropolitan St. Louis

    Missouri · 43229

    Office

    $750.52

    Facility

    $172.44

    $89.89 lower than El Centro for the office setting.

  • Rest Of Missouri

    Missouri · 43229

    Office

    $691.22

    Facility

    $167.79

    $149.19 lower than El Centro for the office setting.

  • Mississippi

    Mississippi · 43229

    Office

    $687.34

    Facility

    $164.52

    $153.07 lower than El Centro for the office setting.

  • Montana**

    Montana · 43229

    Office

    $781.89

    Facility

    $174.66

    $58.52 lower than El Centro for the office setting.

  • North Carolina

    North Carolina · 43229

    Office

    $733.11

    Facility

    $166.57

    $107.30 lower than El Centro for the office setting.

  • North Dakota**

    North Dakota · 43229

    Office

    $773.78

    Facility

    $166.55

    $66.63 lower than El Centro for the office setting.

  • Nebraska

    Nebraska · 43229

    Office

    $722.99

    Facility

    $162.52

    $117.42 lower than El Centro for the office setting.

  • New Hampshire

    New Hampshire · 43229

    Office

    $807.04

    Facility

    $174.92

    $33.37 lower than El Centro for the office setting.

  • Northern Nj

    New Jersey · 43229

    Office

    $894.75

    Facility

    $190.36

    $54.34 higher than El Centro for the office setting.

  • Rest Of New Jersey

    New Jersey · 43229

    Office

    $848.01

    Facility

    $184.92

    $7.60 higher than El Centro for the office setting.

  • New Mexico

    New Mexico · 43229

    Office

    $730.33

    Facility

    $173.50

    $110.08 lower than El Centro for the office setting.

  • Nevada**

    Nevada · 43229

    Office

    $780.28

    Facility

    $172.45

    $60.13 lower than El Centro for the office setting.

  • Nyc Suburbs/Long Island

    New York · 43229

    Office

    $924.65

    Facility

    $202.65

    $84.24 higher than El Centro for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 43229

    Office

    $852.09

    Facility

    $187.18

    $11.68 higher than El Centro for the office setting.

  • Queens

    New York · 43229

    Office

    $914.38

    Facility

    $196.64

    $73.97 higher than El Centro for the office setting.

  • Rest Of New York

    New York · 43229

    Office

    $745.11

    Facility

    $168.25

    $95.30 lower than El Centro for the office setting.

  • Ohio

    Ohio · 43229

    Office

    $725.07

    Facility

    $170.67

    $115.34 lower than El Centro for the office setting.

  • Oklahoma

    Oklahoma · 43229

    Office

    $708.81

    Facility

    $166.56

    $131.60 lower than El Centro for the office setting.

  • Portland

    Oregon · 43229

    Office

    $852.89

    Facility

    $178.26

    $12.48 higher than El Centro for the office setting.

  • Rest Of Oregon

    Oregon · 43229

    Office

    $775.23

    Facility

    $170.43

    $65.18 lower than El Centro for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 43229

    Office

    $813.44

    Facility

    $181.32

    $26.97 lower than El Centro for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 43229

    Office

    $727.48

    Facility

    $170.04

    $112.93 lower than El Centro for the office setting.

  • Puerto Rico

    Puerto Rico · 43229

    Office

    $788.91

    Facility

    $175.00

    $51.50 lower than El Centro for the office setting.

  • Rhode Island

    Rhode Island · 43229

    Office

    $804.20

    Facility

    $176.93

    $36.21 lower than El Centro for the office setting.

  • South Carolina

    South Carolina · 43229

    Office

    $730.11

    Facility

    $169.03

    $110.30 lower than El Centro for the office setting.

  • South Dakota**

    South Dakota · 43229

    Office

    $772.82

    Facility

    $165.59

    $67.59 lower than El Centro for the office setting.

  • Tennessee

    Tennessee · 43229

    Office

    $716.00

    Facility

    $164.03

    $124.41 lower than El Centro for the office setting.

  • Austin

    Texas · 43229

    Office

    $818.55

    Facility

    $176.10

    $21.86 lower than El Centro for the office setting.

  • Beaumont

    Texas · 43229

    Office

    $722.02

    Facility

    $169.45

    $118.39 lower than El Centro for the office setting.

  • Brazoria

    Texas · 43229

    Office

    $773.92

    Facility

    $172.16

    $66.49 lower than El Centro for the office setting.

  • Dallas

    Texas · 43229

    Office

    $778.37

    Facility

    $173.57

    $62.04 lower than El Centro for the office setting.

  • Fort Worth

    Texas · 43229

    Office

    $772.01

    Facility

    $173.28

    $68.40 lower than El Centro for the office setting.

  • Galveston

    Texas · 43229

    Office

    $775.89

    Facility

    $172.91

    $64.52 lower than El Centro for the office setting.

  • Houston

    Texas · 43229

    Office

    $783.39

    Facility

    $180.41

    $57.02 lower than El Centro for the office setting.

  • Rest Of Texas

    Texas · 43229

    Office

    $747.20

    Facility

    $170.94

    $93.21 lower than El Centro for the office setting.

  • Utah

    Utah · 43229

    Office

    $741.24

    Facility

    $170.44

    $99.17 lower than El Centro for the office setting.

  • Virginia

    Virginia · 43229

    Office

    $766.76

    Facility

    $169.85

    $73.65 lower than El Centro for the office setting.

  • Virgin Islands

    United States Virgin Islands · 43229

    Office

    $788.91

    Facility

    $175.00

    $51.50 lower than El Centro for the office setting.

  • Vermont

    Vermont · 43229

    Office

    $768.60

    Facility

    $167.45

    $71.81 lower than El Centro for the office setting.

  • Rest Of Washington

    Washington · 43229

    Office

    $814.82

    Facility

    $175.40

    $25.59 lower than El Centro for the office setting.

  • Seattle (King Cnty)

    Washington · 43229

    Office

    $933.69

    Facility

    $188.63

    $93.28 higher than El Centro for the office setting.

  • Wisconsin

    Wisconsin · 43229

    Office

    $744.94

    Facility

    $163.22

    $95.47 lower than El Centro for the office setting.

  • West Virginia

    West Virginia · 43229

    Office

    $702.06

    Facility

    $174.38

    $138.35 lower than El Centro for the office setting.

  • Wyoming**

    Wyoming · 43229

    Office

    $778.35

    Facility

    $171.13

    $62.06 lower than El Centro for the office setting.

See how rates vary across the country

43229 · 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.

$682.97

$958.88

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$875.101
AL$694.141
AR$682.971
AZ$759.651
CA$840.34–$1,077.4129
CO$822.181
CT$837.471
DC$906.121
DE$773.241
FL$760.00–$829.693
GA$713.84–$795.482
GU$865.841
HI$865.841
IA$718.011
ID$722.331
IL$732.67–$810.964
IN$727.091
KS$712.281
KY$708.081
LA$706.05–$745.152
MA$815.65–$912.072
MD$789.78–$906.123
ME$724.37–$770.972
MI$726.73–$768.402
MN$791.261
MO$691.22–$750.523
MS$687.341
MT$781.891
NC$733.111
ND$773.781
NE$722.991
NH$807.041
NJ$848.01–$894.752
NM$730.331
NV$780.281
NY$745.11–$924.655
OH$725.071
OK$708.811
OR$775.23–$852.892
PA$727.48–$813.442
PR$788.911
RI$804.201
SC$730.111
SD$772.821
TN$716.001
TX$722.02–$818.558
UT$741.241
VA$766.76–$906.122
VI$788.911
VT$768.601
WA$814.82–$933.692
WI$744.941
WV$702.061
WY$778.351

Explore 43229 on the national rate map →

Where does this rate apply?

El Centro is a Medicare payment area. Our Census mapping connects it to 18 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.

Why are the office and facility amounts different?

For 43229 in El Centro, the physician’s office rate is $840.41 and the facility-setting rate is $174.88: a difference of $665.53.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 43229 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$924.45

$840.41 × 110% = $924.45

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.

Compare your contract offer →

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 43229 in El Centro.

PPRRVU2026_Oct_nonQPP.csv

5,158

Code
43229
Physician work
3.40
Practice expense
19.60
Malpractice
0.41

GPCI2026.csv

10

Locality
El Centro
Physician work
1.017
Practice expense
1.096
Malpractice
0.541
Office / nonfacility calculation for 43229 in El Centro
ComponentRVULocality factorAdjusted
Physician work3.40× 1.0173.4578
Practice expense19.60× 1.09621.4816
Malpractice0.41× 0.5410.2218
Total RVUs25.1612
Conversion factor× 33.4009

Office / nonfacility rate, El Centro$840.41

Open 43229 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.41.017
Practice expense19.61.096
Malpractice0.410.541

(3.4 × 1.017 + 19.6 × 1.096 + 0.41 × 0.541) × $33.4009 = $840.41

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.41.017
Practice expense1.421.096
Malpractice0.410.541

(3.4 × 1.017 + 1.42 × 1.096 + 0.41 × 0.541) × $33.4009 = $174.88

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

43229 · Office / nonfacility

$840.41

Effective 2026-10-01

The base rate is $132.71 higher than on 2025-10-01, moving from $707.70 to $840.41 (18.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $707.70changed to$840.41

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.49 changed to 3.40
    • Practice expense RVU 16.55 changed to 19.60
    • Malpractice RVU 0.44 changed to 0.41
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.570 changed to 0.541

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $707.70

    Held through RVU25B, RVU25C, RVU25D.

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 fromOffice / nonfacilityFacilityCMS release
2026-10-01$840.41$174.88RVU26D
2026-07-01$840.41$174.88RVU26C
2026-04-01$840.41$174.88RVU26B
2026-01-01$840.41$174.88RVU26A
2025-10-01$707.70$189.40RVU25D
2025-07-01$707.70$189.40RVU25C
2025-04-01$707.70$189.40RVU25B
2025-01-01$707.70$189.40RVU25A

43229 billing questions

How is ablation distinguished from endoscopic lesion removal?

Use this code for ablation of the esophageal target. Codes 43216 and 43217 describe lesion removal by specific techniques, including forceps or cautery and snare removal.

Can this code be reported for diagnostic esophagoscopy alone?

No. The service must include treatment by ablation; inspection or biopsy without ablation does not support this code.

Is modifier 50 appropriate for ablation on both sides of the esophagus?

No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.

How are related endoscopies priced when performed together?

CMS applies endoscopy-family pricing when related endoscopies are performed together, rather than pricing each related scope service independently.

Does Medicare pay an assistant or co-surgeon for this procedure?

An assistant at surgery is not paid for this service. Co-surgeons and team surgery are not permitted.

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.

RVUs for 43229PPRRVU2026_Oct_nonQPP.csv, line 5,158 (RVU26D)
Geographic factors for El CentroGPCI2026.csv, line 10 (RVU26D)