43213 Esophagoscopy retro balloon
Also known as: retrograde dilation, retrograde balloon dilation
Esophagogastroduodenoscopy (EGD) with retrograde insertion of guidewire or balloon dilation through stricture.
In Plain Language
camera examination with balloon stretching of narrowed esophagus
Clinical Context
Therapeutic procedure for esophageal stricture with retrograde dilation technique. Used when antegrade approach unsuccessful.
RVU Breakdown
| Work RVU | 4.51 |
| Total RVU | 4.51 |
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 4.51, this code ranks in the 31st percentile among Surgery codes — 1.8x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 43213?
CPT 43213 (Esophagoscopy retro balloon) is a Surgery code. Esophagogastroduodenoscopy (EGD) with retrograde insertion of guidewire or balloon dilation through stricture.
What is the wRVU value for CPT 43213?
The work RVU for CPT 43213 is 4.51. This code is primarily used by Gastroenterology.
When is CPT 43213 used?
Therapeutic procedure for esophageal stricture with retrograde dilation technique. Used when antegrade approach unsuccessful.
Track This Code in RVU Edge
Log procedures, calculate wRVUs, and benchmark against MGMA data — all in one app.
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.