43254 Egd endoscopic mucosal resection
Also known as: EGD EMR, endoscopic mucosal resection, cap-assisted EMR
Esophagogastroduodenoscopy with endoscopic mucosal resection of esophageal or gastric lesion. This advanced therapeutic technique removes early neoplasia while preserving underlying muscle.
In Plain Language
removing surface layer of tumor; mucosal stripping technique
Clinical Context
Gold standard for early gastric cancer and Barrett's esophagus with high-grade dysplasia; allows complete histologic assessment and achieves curative resection.
RVU Breakdown
| Work RVU | 4.75 |
| Total RVU | 4.75 |
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 4.75, 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 43254?
CPT 43254 (Egd endoscopic mucosal resection) is a Surgery code. Esophagogastroduodenoscopy with endoscopic mucosal resection of esophageal or gastric lesion. This advanced therapeutic technique removes early neoplasia while preserving underlying muscle.
What is the wRVU value for CPT 43254?
The work RVU for CPT 43254 is 4.75. This code is primarily used by Gastroenterology, Oncology, Surgery.
When is CPT 43254 used?
Gold standard for early gastric cancer and Barrett's esophagus with high-grade dysplasia; allows complete histologic assessment and achieves curative resection.
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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.