Billing code 43244: Variceal ligationMedicare rate & RVUs in Washington
Reports therapeutic upper endoscopy in which an endoscopist places bands on esophageal or gastric varices to treat or prevent variceal bleeding.
CMS doesn’t publish an office rate for 43244 in Washington.
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 43244 covers
During upper endoscopy, the gastroenterologist or other qualified endoscopist identifies varices and deploys bands to close them. The service is used for varices associated with portal hypertension, including varices treated because they are bleeding or to reduce bleeding risk. The treated sites may be in the esophagus, stomach, or both; documentation should identify the varices and describe the ligation performed.
Report this code for endoscopic band treatment, rather than injection therapy reported with 43243. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted for this code.
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 43244 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $216.54 |
| Seattle (King Cnty) | Unavailable | $232.54 |
How the 43244 rate is calculated
Each of 43244’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 · 43244
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.29Practice expense 1.69Malpractice 0.47
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43244
The CMS indicators that decide how 43244 is paid alongside other services.
CMS payment indicators · 43244
Variceal ligation
| 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 | 3 | Endoscopy family rules apply. |
| 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
43244 without 51 · national facility
$215.44
Variceal ligation
43244-51 · Second procedure: 50%
$107.72
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%).
43244 compared with similar codes
Compare codes
43244 vs 43243 vs 43255 vs 43235: national Medicare rates
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How to choose
- 43243Variceal injection
- Both address varices, but 43244 is for band ligation and 43243 is for injection treatment.
- 43255Bleeding control
- 43244 identifies band ligation of varices; 43255 describes endoscopic control of bleeding by other methods.
- 43235Upper GI endoscopy
- 43235 is a diagnostic upper endoscopy with brushing or washing when performed. Choose 43244 when the endoscopist performs variceal band ligation.
43244 billing questions
How does this differ from 43243?
Use 43244 when varices are treated with endoscopic bands. Code 43243 describes injection treatment of varices.
Can 43244 be reported per band placed?
Report the endoscopic ligation service, not a separate unit for each band. Document the treated sites and the ligation performed.
When is 43255 a better fit?
Code 43255 is for endoscopic control of bleeding by methods other than variceal band ligation. Use 43244 when the documented treatment is banding varices.
Should modifier 50 be appended when varices are treated in both the esophagus and stomach?
No. Modifier 50 is inappropriate for this code; the service can involve esophageal varices, gastric varices, or both.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. Related endoscopies performed together are subject to endoscopy family pricing.
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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