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43216 Esophagoscopy lesion removal

Surgery Global 0d

Also known as: EGD with lesion removal, endoscopic lesion ablation

Esophagogastroduodenoscopy (EGD) with excision or removal of esophageal lesion using electrocautery, laser, or hot biopsy forceps.

In Plain Language

camera examination with removal of esophageal growth or abnormality

Clinical Context

Therapeutic procedure for esophageal lesions including polyps, sessile lesions, or cauterization of bleeding lesions.

RVU Breakdown

Work RVU2.24
Total RVU2.24

Est. Medicare Payment

$74.82

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 2.24, this code ranks in the 15th percentile among Surgery codes — 3.6x below the median (8.00). The highest wRVU in this category is 106.19.

Specialties

Gastroenterology

Frequently Asked Questions

What is CPT code 43216?

CPT 43216 (Esophagoscopy lesion removal) is a Surgery code. Esophagogastroduodenoscopy (EGD) with excision or removal of esophageal lesion using electrocautery, laser, or hot biopsy forceps.

What is the wRVU value for CPT 43216?

The work RVU for CPT 43216 is 2.24. This code is primarily used by Gastroenterology.

When is CPT 43216 used?

Therapeutic procedure for esophageal lesions including polyps, sessile lesions, or cauterization of bleeding lesions.

Track This Code in RVU Edge

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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.