GI · CMS status A
43249
EGD with balloon dilation
EGD with transendoscopic balloon dilation.
Work RVU
3.16
2026 Medicare pays
$246.83
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 3.16 + Practice 3.92 + Malpractice 0.31 = 7.39 total
Work (your effort)Practice expenseMalpractice
Billing guidance for 43249 is locked
- When to use it: the exact clinical situations that support billing 43249
- Documentation checklist: the 3 elements your note needs before submitting
- Common pitfalls: the 1 mistakes that get 43249 downcoded or denied
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Common modifiers
59
Common ICD-10 pairings
K22.2K20.9
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.