43278 Ercp lesion ablate with dilate
Also known as: ERCP lesion ablation with dilation, ductal lesion ablation, ampullary lesion ablation
Endoscopic retrograde cholangiopancreatography with ablation of a pancreatic or biliary ductal lesion and ductal dilation. This therapeutic procedure removes lesions.
In Plain Language
removing growth from bile duct; lesion treatment with dilation
Clinical Context
Used for ampullary adenomas, ductal papillomas, or strictures with suspicious lesions; combines ablation with dilation for improved patency.
RVU Breakdown
| Work RVU | 7.72 |
| Total RVU | 7.72 |
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 7.72, this code ranks in the 49th percentile among Surgery codes — 1.0x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 43278?
CPT 43278 (Ercp lesion ablate with dilate) is a Surgery code. Endoscopic retrograde cholangiopancreatography with ablation of a pancreatic or biliary ductal lesion and ductal dilation. This therapeutic procedure removes lesions.
What is the wRVU value for CPT 43278?
The work RVU for CPT 43278 is 7.72. This code is primarily used by Gastroenterology, Oncology, Surgery.
When is CPT 43278 used?
Used for ampullary adenomas, ductal papillomas, or strictures with suspicious lesions; combines ablation with dilation for improved patency.
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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.