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43204 Esophageal scope with sclerosis injection

Surgery Global 0d

Also known as: esophageal sclerotherapy, variceal sclerotherapy

Flexible esophagoscopy (examination of esophagus with flexible scope) via transoral approach with sclerosis injection for hemostasis or varices.

In Plain Language

camera examination with chemical injection to stop esophageal bleeding

Clinical Context

Therapeutic procedure for esophageal varices or bleeding lesions. Sclerosing agent induces thrombosis and hemostasis.

RVU Breakdown

Work RVU2.27
Total RVU2.27

Est. Medicare Payment

$75.82

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 2.27, this code ranks in the 16th percentile among Surgery codes — 3.5x below the median (8.00). The highest wRVU in this category is 106.19.

Specialties

Gastroenterology

Frequently Asked Questions

What is CPT code 43204?

CPT 43204 (Esophageal scope with sclerosis injection) is a Surgery code. Flexible esophagoscopy (examination of esophagus with flexible scope) via transoral approach with sclerosis injection for hemostasis or varices.

What is the wRVU value for CPT 43204?

The work RVU for CPT 43204 is 2.27. This code is primarily used by Gastroenterology.

When is CPT 43204 used?

Therapeutic procedure for esophageal varices or bleeding lesions. Sclerosing agent induces thrombosis and hemostasis.

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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.