$512.56
Use 43211 for endoscopic mucosal resection. Use 43216 when the documented esophageal lesion removal uses the technique represented by that code instead.
On this page
CMS RVU26D · Effective 2026-10-01
43211 Esophageal resection Medicare reimbursement rates in Alaska
Reports flexible transoral endoscopic removal of a superficial esophageal mucosal lesion, such as a selected Barrett-associated neoplastic focus, by mucosal resection. Compare 43211 office and facility rates across CMS payment localities in Alaska.
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.
What does Medicare pay for 43211 in Alaska?
Alaska has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$272.04
1 of 1 localities have a supported rate.
Payment area: Alaska*
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Gastroenterology
About 43211: Flexible esophageal endoscopic mucosal resection
Reports flexible transoral endoscopic removal of a superficial esophageal mucosal lesion, such as a selected Barrett-associated neoplastic focus, by mucosal resection.
43211 represents flexible transoral endoscopic mucosal resection confined to the esophagus. The endoscopist identifies a superficial mucosal abnormality, separates the target tissue from the deeper wall as needed for capture, and removes it for histologic assessment. Gastroenterologists and other physicians trained in therapeutic endoscopy commonly perform this service in a hospital outpatient endoscopy unit or ambulatory surgery center. A typical indication is resection of a selected visible Barrett-associated dysplastic focus or other superficial esophageal neoplasia; this code describes mucosal resection, not sampling alone or treatment by ablation.
Report 43211 when the documented intervention is endoscopic mucosal resection of esophageal tissue, rather than biopsy alone, conventional lesion removal without mucosal resection, or ablation. Document the esophageal site, lesion findings, resection method, and any additional endoscopic work. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing governs payment. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 43211
- 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 RVU4.10 · 66%
- Practice expense (office) RVU1.64 · 26%
- Malpractice RVU0.45 · 7%
71
Medicare services in 2024 · #5134 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.
43211 compared with similar codes
Office rates for Alaska, from the same CMS release.
$532.88
43211 is for mucosal resection; 43217 represents esophageal lesion removal by snare. Select according to the procedure actually performed.
$875.10
43211 removes mucosal tissue for histologic assessment, while 43229 treats esophageal lesions by endoscopic ablation.
$439.49
43202 reports esophageal tissue sampling by biopsy. It does not describe therapeutic mucosal resection of the lesion.
Compare 43211 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alaska* →
Office / nonfacility
Unavailable
Facility
$272.04
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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 43211 in Alaska*.
PPRRVU2026_Oct_nonQPP.csv
5,148
- Code
- 43211
- Physician work
- 4.10
- Practice expense
- 1.64
- Malpractice
- 0.45
GPCI2026.csv
5
- Locality
- Alaska*
- Physician work
- 1.500
- Practice expense
- 1.065
- Malpractice
- 0.551
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.10 | × 1.500 | 6.1500 |
| Practice expense | 1.64 | × 1.065 | 1.7466 |
| Malpractice | 0.45 | × 0.551 | 0.2480 |
| Total RVUs | 8.1445 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alaska*$272.04
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.1 | 1.5 |
| Practice expense | 1.64 | 1.065 |
| Malpractice | 0.45 | 0.551 |
(4.1 × 1.5 + 1.64 × 1.065 + 0.45 × 0.551) × $33.4009 = $272.04
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.
43211 billing questions
When should 43211 be chosen over a lesion-removal code?
Choose 43211 when the physician performs endoscopic mucosal resection of an esophageal lesion. Codes for other removal techniques, such as snare removal, describe a different intervention.
How does 43211 differ from esophageal biopsy?
43211 reports therapeutic mucosal resection, while 43202 describes flexible esophagoscopy with biopsy. Sampling tissue without mucosal resection supports the biopsy code instead.
Can a separate endoscopy be reported during the same session?
When related endoscopies are performed together, CMS endoscopy-family pricing applies. Report the documented services, with payment determined under those family-pricing rules.
Should modifier 50 be appended for lesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this service, so modifier 50 is not appropriate.
What documentation supports reporting 43211?
Document the esophageal lesion's location and findings and that mucosal resection was performed. The note should distinguish resection from biopsy, conventional lesion removal, or ablation.
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.
5,14543206,,Esoph optical endomicroscopy,A,,2.23,7.72,,1.08,,0.24,10.19,3.55,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43200,33.4009,09,0,99,0.00,0.00,0.00
5,1464320F,,Pt talk psychsoc&rx oh dpnd,I,,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
5,14743210,,Egd esophagogastrc fndoplsty,A,,7.56,2.70,NA,2.70,,1.10,11.36,11.36,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43235,33.4009,09,0,99,0.00,0.00,0.00
5,14843211,,Esophagoscop mucosal resect,A,,4.10,1.64,NA,1.64,,0.45,6.19,6.19,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43200,33.4009,09,0,99,0.00,0.00,0.00
5,14943212,,Esophagoscop stent placement,A,,3.32,1.25,NA,1.25,,0.51,5.08,5.08,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43200,33.4009,09,0,99,0.00,0.00,0.00
5,15043213,,Esophagoscopy retro balloon,A,,4.51,32.37,,1.57,,0.67,37.55,6.75,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43200,33.4009,09,0,99,0.00,0.00,0.00
5,15143214,,Esophagosc dilate balloon 30,A,,3.32,1.22,NA,1.22,,0.50,5.04,5.04,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43200,33.4009,09,0,99,0.00,0.00,0.00
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
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