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43226 Esophageal endoscopy dilation

Surgery Global 0d

Also known as: esophageal dilation, esophagoscopy with dilation

Esophagoscopy (flexible) with dilation of esophageal stricture using sequential dilators or balloon technique.

In Plain Language

camera examination with stretching of esophagus narrowing

Clinical Context

Therapeutic procedure for esophageal stricture. Sequential dilation allows controlled enlargement without perforation.

RVU Breakdown

Work RVU2.18
Total RVU2.18

Est. Medicare Payment

$72.81

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 2.18, this code ranks in the 15th percentile among Surgery codes — 3.7x below the median (8.00). The highest wRVU in this category is 106.19.

Specialties

Gastroenterology

Frequently Asked Questions

What is CPT code 43226?

CPT 43226 (Esophageal endoscopy dilation) is a Surgery code. Esophagoscopy (flexible) with dilation of esophageal stricture using sequential dilators or balloon technique.

What is the wRVU value for CPT 43226?

The work RVU for CPT 43226 is 2.18. This code is primarily used by Gastroenterology.

When is CPT 43226 used?

Therapeutic procedure for esophageal stricture. Sequential dilation allows controlled enlargement without perforation.

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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.