Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 43214 Fee Schedule
Medicare rates as of October 2026
CPT 43214 is classified under Surgery, in the Surgical Procedures on the Digestive System subgroup.
Esophagosc Dilate Balloon 30, Esophagoscopy Flexible Transoral With Dilation Of Esophagus With Balloon 30 Mm Diameter Or Larger Includes Fluoroscopic Guidance When Performed
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | GC - Service performed by resident under supervision XS - Separate Structure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $168.34 national non-facility rate (2026) · View Medicare rates for 43214 |
| Medicaid Fee Schedule | $134.68 median of the 8 states in the free preview · View Medicaid rates for 43214 |
National average reimbursement for CPT 43214 by major payers:
$265.41
BCBS / Anthem
$269.52
UnitedHealthcare
$271.99
Aetna
$331.81
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 43214.
CPT 43214
5 of 25 sample ratesHigher to lower in this preview
Oakwood Surgery Center, Ltd., LLP
Oakwood Surgery Center Ltd LLP
$2,782.00Published rateHouston Surgery Center
Houston Surgery Center Lp
$981.00Published ratePremier Asc LLC, Premier Orthopaedic Surgery Center
$845.00Published ratePacific Cataract And Laser Institute Inc PC
Pacific Cataract And Laser Institute, Inc., PC
$624.00Published rateCenter For Spine & Pain Medicine PC, Cspm Gsv Asc
Center For Spine And Pain Medici
$390.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 43214 vs. Other Surgical Procedures on the Digestive System Codes
The table lists codes related to 43214. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 43212-CPT | Moderate | Esophagoscop Stent Placement, Esophagoscopy Flexible Transoral With Placement Of Endoscopic Stent Includes Pre And Post Dilation And Guide Wire Passage When Performed |
| 43213-CPT | High | Esophagoscopy Retro Balloon, Esophagoscopy Flexible Transoral With Dilation Of Esophagus By Balloon Or Dilator Retrograde Includes Fluoroscopic Guidance When Performed |
| 43214-CPT | Moderate | Esophagosc Dilate Balloon 30, Esophagoscopy Flexible Transoral With Dilation Of Esophagus With Balloon 30 Mm Diameter Or Larger Includes Fluoroscopic Guidance When Performed |
| 43215-CPT | Moderate | Esophagoscopy Rigid Or Flexib, Esophagoscopy Rigid Or Flexible With Removal Of Foreignbody Esophagoscopy Rigid Or Flexible With Removal Of Foreign |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43214. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43214 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 43214) and we'll show you how you compare in 15 minutes or less.