Billing code 43460: Variceal tamponadeMedicare rate & RVUs in Texas
Reports pressure-based treatment of esophageal varices, typically using balloon tamponade to control acute bleeding while definitive care is arranged.
CMS doesn’t publish an office rate for 43460 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 43460 covers
This service uses pressure, commonly from an inflated balloon on a tamponade tube, to compress esophageal varices and control acute hemorrhage. It is typically performed by a physician in a hospital setting for a patient with active variceal bleeding, often as an urgent measure while further treatment is arranged.
Report the service when the physician performs pressure treatment, and document the bleeding indication, device, and treatment performed. The 0-day global period includes same-day preoperative and postoperative care. When other procedures are performed in the same session, Medicare pays the highest-valued procedure in full and applies the multiple-procedure reduction to the others. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
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.
Where 43460 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $189.27 |
| Beaumont | Unavailable | $182.21 |
| Brazoria | Unavailable | $185.16 |
| Dallas | Unavailable | $186.63 |
| Fort Worth | Unavailable | $186.31 |
| Galveston | Unavailable | $185.94 |
| Houston | Unavailable | $193.63 |
| Rest Of Texas | Unavailable | $183.80 |
How the 43460 rate is calculated
Each of 43460’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 43460
RVUs × geographic indexes × conversion factor
Work3.70
3.70 RVUs× 1.000 GPCI
Practice expense1.50
1.50 RVUs× 1.000 GPCI
Malpractice0.42
0.42 RVUs× 1.000 GPCI
Adjusted RVUs
5.6200
Conversion factor
$33.4009
Medicare rate
$187.71
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43460
The CMS indicators that decide how 43460 is paid alongside other services.
CMS payment indicators · 43460
Variceal tamponade
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
43460 without 51 · national facility
$187.71
Variceal tamponade
43460-51 · Second procedure: 50%
$93.86
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
43460 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 43244Variceal ligation
- Choose this code for pressure tamponade of esophageal varices. Choose 43244 when an endoscope is used to place bands on esophageal or gastric varices.
- 43255Bleeding control
- This code describes pressure treatment of esophageal varices. Code 43255 describes endoscopic control of bleeding by a method such as coagulation or clipping.
- 43400Varix ligation
- Both concern esophageal varices, but 43400 describes ligation; 43460 describes pressure treatment, typically with balloon tamponade.
43460 billing questions
How is this different from endoscopic variceal banding?
This code describes pressure tamponade, generally using an inflated balloon to compress bleeding varices. Endoscopic banding uses an endoscope to place bands on varices.
What documentation supports reporting this service?
Document the acute bleeding indication, the pressure-tamponade device used, and the treatment performed to compress the esophageal varices.
Are same-day preoperative and postoperative services included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
How is payment handled when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and the other procedure or procedures are subject to the standard multiple-procedure reduction.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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