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See a sample rate comparisonCPT 43229 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Esophagoscopy Lesion Ablate, Esophagoscopy Flexible Transoral With Ablation Of Tumor S Polyp S Or Other Lesion S Includes Pre And Post Dilation And Guide Wire Passage 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 | None SG - Scene to Hospital ESRD facility 59 - Distinct Procedural Service GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 43229 |
| Medicaid Fee Schedule | View Medicaid rates for 43229 |
National average reimbursement for CPT 43229 by major payers:
$806.85
$949.85
$976.41
$375.83
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CPT 43229
5 of 25 sample ratesHigher to lower in this preview
Endoscopy Center Of South Sacramento, LLC, Endoscopy Center Of South Sacramento
Endoscopy Center Of South Sacramento LLC
$3,430.00Published rateSurgical Specialty Center Of Mid Atlantic, LLC
Surgical Specialty Center Of Mid-Atlantic, LLC
$2,307.00Published rateInstitute For Low Back Care LLC
$1,530.00Published rateHabana Ambulatory Surgery Center LLC
$1,129.00Published rateEye Surgery Center Of Saint Augustine Inc
$500.00Published rate
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See a sample payer proposalCPT 43229 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43229 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 43229 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 43216-CPT | Moderate | Esophagoscopy Rigid Or Flexib, Esophagoscopy Rigid Or Flexible With Removal Of Tumor(S) Polyp(S) Or Other Lesion(S) By Hot Biopsy Forceps Or Bipolar Cautery |
| 43217-CPT | Moderate | Esophagoscopy Flexible Transoral; With Removal Tumor(S) Polyp(S) Or Other Lesion(S) By Snare Technique (Revised 01/01/2014) |
| 43220-CPT | Moderate | Esophagus Enlargement, Exam Of The Esophagus Aided By A Scope (Endoscope). The Procedure Inserts A Balloon That Is Inflated In Order To Enlarge Or Open Up The Esophagus. |
| 43229-CPT | Moderate | Esophagoscopy Lesion Ablate, Esophagoscopy Flexible Transoral With Ablation Of Tumor S Polyp S Or Other Lesion S Includes Pre And Post Dilation And Guide Wire Passage When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43229. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43229 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.
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