How Much Does Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm Cost on Medicare?

The data suggests significant pricing inconsistencies for CPT 43249. With a 3.2x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.

Costs have risen 17.3% since 2014, outpacing inflation and raising questions about whether reimbursement rates reflect actual costs.

This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.