$391.30
Use 43200 for brush or wash collection; use 43202 when forceps are used to obtain esophageal tissue for biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
43200 Esophagoscopy Medicare reimbursement rates in Wyoming
Reports flexible transoral examination of the esophagus when the clinician collects cells or material by brushing or washing during the procedure. Compare 43200 office and facility rates across CMS payment localities in Wyoming.
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 43200 in Wyoming?
Wyoming 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
$285.09
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$77.67
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 43200: Flexible esophageal endoscopy with brushings
Reports flexible transoral examination of the esophagus when the clinician collects cells or material by brushing or washing during the procedure.
A flexible scope is passed through the mouth to examine the esophagus. During the examination, the clinician may brush or wash a mucosal area to collect cells or other material for laboratory analysis. Gastroenterologists commonly perform this service in an outpatient endoscopy unit or hospital; otolaryngologists may perform it in settings where they evaluate the esophagus. The code is limited to esophageal examination and sampling, rather than examination of the stomach or duodenum.
Report the service when documentation supports flexible transoral esophagoscopy and any brush or wash sampling performed. A forceps tissue biopsy is a different service. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this anatomy. Medicare does not pay an assistant at surgery, co-surgeons, or a surgical team for this code.
CMS billing rules for 43200
- 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 RVU1.38 · 16%
- Practice expense (office) RVU7.00 · 81%
- Malpractice RVU0.21 · 2%
3.2K
Medicare services in 2024 · #2123 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.
43200 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$320.57
43200 examines the esophagus. Choose 43235 when the endoscopic examination extends through the stomach and includes the duodenum.
No office rate
43231 includes endoscopic ultrasound evaluation of the esophagus; 43200 is an inspection with brush or wash sampling.
Compare 43200 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
Wyoming** →
Office / nonfacility
$285.09
Facility
$77.67
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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 43200 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,140
- Code
- 43200
- Physician work
- 1.38
- Practice expense
- 7.00
- Malpractice
- 0.21
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.38 | × 1.000 | 1.3800 |
| Practice expense | 7.00 | × 1.000 | 7.0000 |
| Malpractice | 0.21 | × 0.740 | 0.1554 |
| Total RVUs | 8.5354 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$285.09
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.38 | 1 |
| Practice expense | 7 | 1 |
| Malpractice | 0.21 | 0.74 |
(1.38 × 1 + 7 × 1 + 0.21 × 0.74) × $33.4009 = $285.09
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.38 | 1 |
| Practice expense | 0.79 | 1 |
| Malpractice | 0.21 | 0.74 |
(1.38 × 1 + 0.79 × 1 + 0.21 × 0.74) × $33.4009 = $77.67
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.
43200 billing questions
When should 43200 be chosen over 43202?
Choose 43200 when the esophageal specimen is collected by brushing or washing. Use 43202 when the clinician obtains tissue with forceps for biopsy.
Does the code include the brush or wash collection?
Yes. Brush or wash specimen collection during the esophagoscopy is included; do not report a separate service solely for that collection.
Can modifier 50 be used for this procedure?
No. Modifier 50 is inappropriate for this esophageal service.
How does Medicare handle same-session procedures?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction.
What same-day care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
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.
5,13743196,,Esophagoscp guide wire dilat,A,,3.23,1.46,NA,1.46,,0.45,5.14,5.14,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43191,33.4009,09,0,99,0.00,0.00,0.00
5,13843197,,Esophagoscopy flex dx brush,A,,1.48,4.21,,0.36,,0.21,5.90,2.05,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,13943198,,Esophagosc flex trnsn biopsy,A,,1.77,4.51,,0.43,,0.25,6.53,2.45,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43197,33.4009,09,0,99,0.00,0.00,0.00
5,14043200,,Esophagoscopy flexible brush,A,,1.38,7.00,,0.79,,0.21,8.59,2.38,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,14143201,,Esoph scope w/submucous inj,A,,1.68,6.43,,0.86,,0.22,8.33,2.76,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43200,33.4009,09,0,99,0.00,0.00,0.00
5,14243202,,Esophagoscopy flex biopsy,A,,1.68,9.88,,0.90,,0.21,11.77,2.79,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43200,33.4009,09,0,99,0.00,0.00,0.00
5,14343204,,Esoph scope w/sclerosis inj,A,,2.27,1.09,NA,1.09,,0.25,3.61,3.61,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43200,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,