# CPT 43238: Egd Intrmural Us Needle Aspirate/biopsy Esophags

Medicare CPT 43238 pays $204.41 in a non-facility setting and $204.41 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $189.66 in Arkansas to $269.14 in Alaska, a 42% spread.

Web page: https://www.med-reveal.com/rates/43238-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Gastroenterology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $204.41 |
| National facility | $204.41 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $269.14 | $269.14 |
| District of Columbia | $223.03 | $223.03 |
| New York | $222.38 | $222.38 |
| New Jersey | $219.43 | $219.43 |
| Florida | $218.50 | $218.50 |
| Illinois | $216.45 | $216.45 |
| Connecticut | $214.38 | $214.38 |
| Washington | $213.16 | $213.16 |
| Massachusetts | $212.66 | $212.66 |
| California | $212.46 | $212.46 |
| Maryland | $209.62 | $209.62 |
| Rhode Island | $207.19 | $207.19 |
| Michigan | $207.10 | $207.10 |
| Colorado | $206.29 | $206.29 |
| Hawaii | $205.64 | $205.64 |
| Pennsylvania | $205.54 | $205.54 |
| Georgia | $205.02 | $205.02 |
| New Hampshire | $204.79 | $204.79 |
| Puerto Rico | $204.79 | $204.79 |
| Virgin Islands | $204.79 | $204.79 |
| Montana | $204.38 | $204.38 |
| Oregon | $204.33 | $204.33 |
| West Virginia | $203.66 | $203.66 |
| Texas | $203.28 | $203.28 |
| Delaware | $202.96 | $202.96 |
| New Mexico | $202.88 | $202.88 |
| Nevada | $202.01 | $202.01 |
| Arizona | $200.62 | $200.62 |
| Wyoming | $200.59 | $200.59 |
| Louisiana | $200.40 | $200.40 |
| Ohio | $199.82 | $199.82 |
| Missouri | $199.73 | $199.73 |
| Utah | $199.67 | $199.67 |
| Virginia | $199.17 | $199.17 |
| South Carolina | $198.10 | $198.10 |
| Kentucky | $197.16 | $197.16 |
| Vermont | $196.61 | $196.61 |
| Maine | $196.52 | $196.52 |
| North Dakota | $195.68 | $195.68 |
| Minnesota | $195.64 | $195.64 |
| North Carolina | $195.48 | $195.48 |
| Oklahoma | $195.35 | $195.35 |
| South Dakota | $194.66 | $194.66 |
| Mississippi | $193.06 | $193.06 |
| Indiana | $192.91 | $192.91 |
| Tennessee | $192.69 | $192.69 |
| Idaho | $192.34 | $192.34 |
| Wisconsin | $191.97 | $191.97 |
| Kansas | $191.93 | $191.93 |
| Alabama | $191.27 | $191.27 |
| Nebraska | $191.11 | $191.11 |
| Iowa | $190.95 | $190.95 |
| Arkansas | $189.66 | $189.66 |

## Related codes

- 10140: I&d Hematoma Seroma/fluid Collection — https://www.med-reveal.com/rates/10140-cpt-fee-schedule
- 11055: Paring/cutting Benign Hyperkeratotic Lesion 1 — https://www.med-reveal.com/rates/11055-cpt-fee-schedule
- 11056: Paring/cutting Benign Hyperkeratotic Lesion 2-4 — https://www.med-reveal.com/rates/11056-cpt-fee-schedule
- 11057: Paring/cutting Benign Hyperkeratotic Lesion >4 — https://www.med-reveal.com/rates/11057-cpt-fee-schedule
- 11403: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 2.1-3.0 Cm — https://www.med-reveal.com/rates/11403-cpt-fee-schedule
- 11404: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 3.1-4.0 Cm — https://www.med-reveal.com/rates/11404-cpt-fee-schedule
- 11406: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l >4.0 Cm — https://www.med-reveal.com/rates/11406-cpt-fee-schedule
- 11603: Excision Mal Lesion Trunk/arm/leg 2.1-3.0 Cm — https://www.med-reveal.com/rates/11603-cpt-fee-schedule

Commercial negotiated rates for 43238 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules