$196.25
Choose 43453 for fluoroscopic balloon-catheter dilation; choose 43450 for dilation with an unguided sound or bougie.
On this page
CMS RVU26D · Effective 2026-10-01
43453 Esophageal dilation Medicare reimbursement rates in Nebraska
Reports balloon dilation of an esophageal narrowing when the catheter is positioned and the procedure is performed with fluoroscopic guidance. Compare 43453 office and facility rates across CMS payment localities in Nebraska.
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 43453 in Nebraska?
Nebraska 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
$767.89
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$71.77
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 43453: Fluoroscopic balloon esophageal dilation
Reports balloon dilation of an esophageal narrowing when the catheter is positioned and the procedure is performed with fluoroscopic guidance.
This service enlarges a narrowed segment of the esophagus by inflating a balloon catheter under fluoroscopic guidance. It may be used for conditions such as a benign stricture, ring, or web that limits passage through the esophagus. A gastroenterologist or interventional radiologist typically performs the dilation in a hospital or outpatient procedure setting. The fluoroscopic balloon approach distinguishes this service from dilation performed through an endoscope or with an unguided bougie.
Report the service when the esophageal dilation uses a balloon catheter with fluoroscopic guidance. Documentation should identify the narrowing and its location, the balloon-catheter technique, and the fluoroscopic guidance used. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 43453
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- 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 RVU1.37 · 6%
- Practice expense (office) RVU23.35 · 94%
- Malpractice RVU0.18 · 1%
1.4K
Medicare services in 2024 · #2706 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.
43453 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$1,090.72
43249 describes endoscopic balloon dilation with a balloon under 30 mm. This code describes fluoroscopic balloon-catheter dilation.
No office rate
43233 describes endoscopic balloon dilation with a balloon 30 mm or larger; 43453 identifies the fluoroscopic balloon-catheter approach.
Compare 43453 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
Nebraska →
Office / nonfacility
$767.89
Facility
$71.77
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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 43453 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
5,251
- Code
- 43453
- Physician work
- 1.37
- Practice expense
- 23.35
- Malpractice
- 0.18
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.37 | × 1.000 | 1.3700 |
| Practice expense | 23.35 | × 0.923 | 21.5521 |
| Malpractice | 0.18 | × 0.378 | 0.0680 |
| Total RVUs | 22.9901 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$767.89
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.37 | 1 |
| Practice expense | 23.35 | 0.923 |
| Malpractice | 0.18 | 0.378 |
(1.37 × 1 + 23.35 × 0.923 + 0.18 × 0.378) × $33.4009 = $767.89
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.37 | 1 |
| Practice expense | 0.77 | 0.923 |
| Malpractice | 0.18 | 0.378 |
(1.37 × 1 + 0.77 × 0.923 + 0.18 × 0.378) × $33.4009 = $71.77
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.
43453 billing questions
How does this differ from 43450?
43453 is for balloon-catheter dilation under fluoroscopic guidance. 43450 describes dilation with an unguided sound or bougie.
When would an endoscopic dilation code be more appropriate?
Use an endoscopic dilation code when dilation is performed through an endoscope. For example, 43249 and 43233 distinguish endoscopic balloon dilation by balloon diameter.
Is same-day postoperative care separately reported?
Same-day preoperative and postoperative care is included in this service's 0-day global period.
Can modifier 50 be used for dilation on both sides?
No. The code's descriptor or anatomy makes bilateral adjustment inappropriate.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple-procedure reduction.
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.
5,24843420,,Repair esophagus opening,A,,16.36,7.56,NA,7.56,,2.39,26.31,26.31,0,090,0.09,0.81,0.10,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,24943425,,Repair esophagus opening,A,,24.41,10.62,NA,10.62,,6.16,41.19,41.19,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,25043450,,Dilate esophagus 1/mult pass,A,,1.25,4.95,,0.79,,0.15,6.35,2.19,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,25143453,,Dilate esophagus,A,,1.37,23.35,,0.77,,0.18,24.90,2.32,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,25243460,,Pressure treatment esophagus,A,,3.70,1.50,NA,1.50,,0.42,5.62,5.62,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,25343496,,Free jejunum flap microvasc,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,25443497,,Transorl lwr esophgl myotomy,A,,12.96,6.75,NA,6.75,,1.80,21.51,21.51,0,090,0.09,0.81,0.10,3,0,1,0,0,9,43235,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068