# CPT 43249: Egd Balloon Dilation Esophagus <30 Mm Diam

Medicare 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.

Web page: https://www.med-reveal.com/rates/43249-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Gastroenterology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $1,180.39 |
| National facility | $136.28 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| District of Columbia | $1,379.08 | $149.11 |
| California | $1,377.50 | $142.03 |
| Washington | $1,332.71 | $142.42 |
| 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 | $1,228.35 | $139.86 |
| New Hampshire | $1,223.56 | $136.64 |
| Rhode Island | $1,216.71 | $138.14 |
| Minnesota | $1,204.76 | $130.36 |
| Florida | $1,193.48 | $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 | $1,132.65 | $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 |

## 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 43249 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