No office rate
43231 covers esophageal EUS examination without needle sampling. Choose 43232 when the endoscopist also performs ultrasound-guided needle aspiration or biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
43232 Esophageal EUS Medicare reimbursement rates in New York
Reports flexible esophagoscopy with ultrasound-guided needle sampling of tissue or a lesion in the esophageal wall or nearby structures. Compare 43232 office and facility rates across CMS payment localities in New York.
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 43232 in New York?
New York has 5 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 5 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$171.12–$204.97
5 of 5 localities have a supported rate.
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.
Where 43232 pays more and less in New York
Gastroenterology
About 43232: Esophagoscopy with EUS-guided needle biopsy
Reports flexible esophagoscopy with ultrasound-guided needle sampling of tissue or a lesion in the esophageal wall or nearby structures.
A gastroenterologist passes a flexible endoscope through the mouth to examine the esophagus and uses endoscopic ultrasound to guide a needle into tissue for aspiration or biopsy. Typical targets include an esophageal subepithelial lesion or a mediastinal lymph node or mass accessible from the esophagus. The service is generally performed in a procedural endoscopy setting; it is distinct from sampling performed during an examination that continues into the stomach or duodenum.
Report this code when the record supports both esophagoscopy and ultrasound-guided intramural or transmural needle sampling. Document the examination extent, ultrasound findings, target, and needle sampling performed; multiple needle passes are part of the sampling service, not separate units per pass. The code 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 applies. Modifier 50 is inappropriate. CMS permits co-surgeons, does not permit team surgery, and does not pay an assistant at surgery.
CMS billing rules for 43232
- 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 RVU3.50 · 66%
- Practice expense (office) RVU1.42 · 27%
- Malpractice RVU0.39 · 7%
325
Medicare services in 2024 · #3934 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.
43232 compared with similar codes
Office rates for New York, from the same CMS release.
No office rate
43238 is the EGD-route code for EUS-guided needle sampling. Use 43232 for sampling performed through an esophagoscopy focused on the esophagus.
$399.57–$494.31
43239 reports EGD with mucosal biopsy. 43232 applies when a needle is guided by endoscopic ultrasound to sample tissue within or beyond the esophageal wall.
Compare 43232 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.
5 of 5 payment localities
Manhattan →
Office / nonfacility
Unavailable
Facility
$200.16
Nyc Suburbs/Long Island →
Office / nonfacility
Unavailable
Facility
$204.97
Poughkpsie/N Nyc Suburbs →
Office / nonfacility
Unavailable
Facility
$189.86
Queens →
Office / nonfacility
Unavailable
Facility
$199.23
Rest Of New York →
Office / nonfacility
Unavailable
Facility
$171.12
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
43232 billing questions
When should this be chosen instead of 43231?
Use 43232 when ultrasound-guided needle aspiration or biopsy is performed. 43231 describes esophagoscopy with ultrasound examination without needle sampling.
How does this differ from an EGD with EUS-guided sampling?
43232 describes an esophagoscopy service focused on the esophagus and targets accessible from it. When the endoscopic examination and sampling are performed through an EGD route, consider the applicable EGD sampling code, such as 43238.
Are multiple needle passes reported as separate units?
No. The needle sampling is reported as the procedure, not as a separate unit for each pass. Document the target and sampling performed.
Can modifier 50 be used for bilateral sampling?
No. CMS identifies bilateral adjustment as inappropriate for this code, even when targets are sampled on both sides.
How does CMS handle related endoscopies performed together?
CMS endoscopy family pricing applies when related endoscopies are performed together. The code also has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant or another surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons are permitted, while team surgery is 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.
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
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