43198 Esophagosc flex trnsn biopsy
Also known as: flexible esophagoscopy with biopsy, esophageal biopsy
Flexible esophagoscopy (examination of esophagus with flexible scope) via transoral approach with transmucosal tissue biopsy.
In Plain Language
camera examination of esophagus with tissue sample
Clinical Context
Diagnostic procedure for esophageal lesion evaluation with tissue diagnosis. Most common approach for histologic analysis.
RVU Breakdown
| Work RVU | 1.77 |
| Total RVU | 1.77 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 0-day global period, meaning pre- and post-operative E&M visits are billable separately on the same day. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 1.77, this code ranks in the 12th percentile among Surgery codes — 4.5x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 43198?
CPT 43198 (Esophagosc flex trnsn biopsy) is a Surgery code. Flexible esophagoscopy (examination of esophagus with flexible scope) via transoral approach with transmucosal tissue biopsy.
What is the wRVU value for CPT 43198?
The work RVU for CPT 43198 is 1.77. This code is primarily used by Gastroenterology.
When is CPT 43198 used?
Diagnostic procedure for esophageal lesion evaluation with tissue diagnosis. Most common approach for histologic analysis.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.