# CPT 43257: Upper GI endoscopy with delivery of thermal energy to gastroesophageal junction

Medicare CPT 43257 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 $189.49 in Arkansas to $268.82 in Alaska, a 42% spread.

Web page: https://www.med-reveal.com/rates/43257-cpt-fee-schedule
Section: Surgery and Procedures

## 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 | $268.82 | $268.82 |
| District of Columbia | $223.05 | $223.05 |
| New York | $222.48 | $222.48 |
| New Jersey | $219.44 | $219.44 |
| Florida | $218.82 | $218.82 |
| Illinois | $216.76 | $216.76 |
| Connecticut | $214.44 | $214.44 |
| Washington | $213.08 | $213.08 |
| Massachusetts | $212.60 | $212.60 |
| California | $212.30 | $212.30 |
| Maryland | $209.64 | $209.64 |
| Michigan | $207.24 | $207.24 |
| Rhode Island | $207.15 | $207.15 |
| Colorado | $206.21 | $206.21 |
| Pennsylvania | $205.56 | $205.56 |
| Hawaii | $205.50 | $205.50 |
| Georgia | $205.09 | $205.09 |
| Puerto Rico | $204.78 | $204.78 |
| Virgin Islands | $204.78 | $204.78 |
| New Hampshire | $204.75 | $204.75 |
| Montana | $204.38 | $204.38 |
| Oregon | $204.24 | $204.24 |
| West Virginia | $203.80 | $203.80 |
| Texas | $203.25 | $203.25 |
| New Mexico | $202.94 | $202.94 |
| Delaware | $202.92 | $202.92 |
| Nevada | $201.96 | $201.96 |
| Arizona | $200.57 | $200.57 |
| Wyoming | $200.51 | $200.51 |
| Louisiana | $200.42 | $200.42 |
| Ohio | $199.83 | $199.83 |
| Missouri | $199.73 | $199.73 |
| Utah | $199.63 | $199.63 |
| Virginia | $199.07 | $199.07 |
| South Carolina | $198.05 | $198.05 |
| Kentucky | $197.13 | $197.13 |
| Vermont | $196.45 | $196.45 |
| Maine | $196.39 | $196.39 |
| North Dakota | $195.49 | $195.49 |
| Minnesota | $195.40 | $195.40 |
| North Carolina | $195.36 | $195.36 |
| Oklahoma | $195.27 | $195.27 |
| South Dakota | $194.43 | $194.43 |
| Mississippi | $192.97 | $192.97 |
| Indiana | $192.74 | $192.74 |
| Tennessee | $192.53 | $192.53 |
| Idaho | $192.16 | $192.16 |
| Kansas | $191.76 | $191.76 |
| Wisconsin | $191.74 | $191.74 |
| Alabama | $191.13 | $191.13 |
| Nebraska | $190.90 | $190.90 |
| Iowa | $190.75 | $190.75 |
| Arkansas | $189.49 | $189.49 |

## Related codes

- 40490: Biopsy of lip — https://www.med-reveal.com/rates/40490-cpt-fee-schedule
- 40650: Repair lip, vermilion only — https://www.med-reveal.com/rates/40650-cpt-fee-schedule
- 41010: Frenotomy, lingual — https://www.med-reveal.com/rates/41010-cpt-fee-schedule
- 41112: Excision of lesion of tongue — https://www.med-reveal.com/rates/41112-cpt-fee-schedule
- 41599: Unlisted procedure, tongue/floor of mouth — https://www.med-reveal.com/rates/41599-cpt-fee-schedule
- 42700: Incision and drainage of peritonsillar abscess — https://www.med-reveal.com/rates/42700-cpt-fee-schedule
- 42820: Tonsillectomy and adenoidectomy, under age 12 — https://www.med-reveal.com/rates/42820-cpt-fee-schedule
- 42821: Tonsillectomy and adenoidectomy, age 12 or over — https://www.med-reveal.com/rates/42821-cpt-fee-schedule

Commercial negotiated rates for 43257 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