43242 Egd ultrasound fine needle biopsy/aspiration
Also known as: EUS-guided FNA, endoscopic ultrasound biopsy
Esophagogastroduodenoscopy (EGD) with endoscopic ultrasound and fine needle aspiration/biopsy of perigastric or pancreatic tissue structures.
In Plain Language
camera examination with ultrasound and needle sampling of deep structures
Clinical Context
Diagnostic procedure for tissue sampling of perigastric and pancreatic lesions under ultrasound guidance. Important for pancreatic cancer diagnosis.
RVU Breakdown
| Work RVU | 4.61 |
| Total RVU | 4.61 |
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 4.61, this code ranks in the 32nd percentile among Surgery codes — 1.7x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 43242?
CPT 43242 (Egd ultrasound fine needle biopsy/aspiration) is a Surgery code. Esophagogastroduodenoscopy (EGD) with endoscopic ultrasound and fine needle aspiration/biopsy of perigastric or pancreatic tissue structures.
What is the wRVU value for CPT 43242?
The work RVU for CPT 43242 is 4.61. This code is primarily used by Gastroenterology, Surgical Oncology.
When is CPT 43242 used?
Diagnostic procedure for tissue sampling of perigastric and pancreatic lesions under ultrasound guidance. Important for pancreatic cancer diagnosis.
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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.