CPT 43249

Egd Balloon Dilation Esophagus <30 Mm Diam

CPT 43249 pays $1,180.39 in a non-facility setting and $136.28 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $1,022.75 in Arkansas to $1,379.08 in District of Columbia, a 35% spread.

National non-facility rate

$1,180.39

Office and other outpatient settings

Facility rate
$136.28

Hospital and ASC settings

Highest state
$1,379.08

District of Columbia

Lowest state
$1,022.75

Arkansas · 35% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $1,180.39
CPT 43249 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $1,180.39, national facility $136.28.
StateRate compared visuallyNon-facilityFacility
District of Columbia
$1,379.08$149.11
California
$1,377.50$142.02
Washington
$1,332.70$142.41
Hawaii
$1,324.61$137.46
New Jersey
$1,322.21$146.54
Massachusetts
$1,315.11$142.05
New York
$1,313.36$148.55
Alaska
$1,289.74$177.76
Connecticut
$1,267.66$143.15
Colorado
$1,248.58$137.65
Oregon
$1,236.28$136.31
Maryland
$1,228.34$139.86
New Hampshire
$1,223.56$136.64
Rhode Island
$1,216.71$138.14
Minnesota
$1,204.76$130.36
Florida
$1,193.49$145.89
Puerto Rico
$1,192.16$136.56
Virgin Islands
$1,192.16$136.56
Montana
$1,180.37$136.26
Nevada
$1,179.80$134.64
Wyoming
$1,177.78$133.67
North Dakota
$1,174.44$130.32
South Dakota
$1,173.73$129.62
Delaware
$1,166.81$135.22
Vermont
$1,164.60$130.93
Texas
$1,163.36$135.43
Pennsylvania
$1,159.65$136.94
Virginia
$1,159.02$132.66
Illinois
$1,153.25$144.38
Arizona
$1,145.36$133.61
Georgia
$1,132.64$136.56
Maine
$1,128.43$130.78
Wisconsin
$1,127.95$127.69
Michigan
$1,118.38$137.95
Utah
$1,114.35$132.89
North Carolina
$1,104.17$130.02
South Carolina
$1,096.54$131.78
Indiana
$1,096.14$128.25
New Mexico
$1,092.47$135.02
Missouri
$1,091.02$132.87
Nebraska
$1,090.72$127.01
Idaho
$1,088.43$127.84
Louisiana
$1,086.59$133.32
Ohio
$1,086.20$132.93
Iowa
$1,082.25$126.88
Tennessee
$1,077.15$128.05
Kansas
$1,071.40$127.52
Oklahoma
$1,062.22$129.82
Kentucky
$1,059.26$131.05
West Virginia
$1,042.76$135.43
Alabama
$1,040.60$127.00
Mississippi
$1,027.16$128.18
Arkansas
$1,022.75$125.86

Billed by 1 specialties

Commercial rates for 43249

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates