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CPT 43195: Rigid Endoscope Esophageal Balloon Dilation
CPT code 43195 represents rigid endoscope–assisted esophageal balloon dilation with balloon expansion to less than 30 mm. This endoscopic therapeutic procedure is used to widen focal esophageal strictures and is performed in ambulatory surgical centers or hospital outpatient departments. The code matters nationally because esophageal dilation is a common intervention across gastroenterology and thoracic surgery practices for symptom relief and to reduce complication risk from progressive dysphagia.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, common sites of service, and a summary of payer coverage considerations. The publication provides benchmarks and policy-relevant details that support coding accuracy, payer negotiation, and operational planning for facilities and providers. Data not available in the input is noted where specific payer policies, reimbursement rates, associated taxonomies, and ICD-10 diagnosis pairings would normally be summarized.
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Billing Code Overview
CPT code 43195 describes a procedure in which a provider introduces a rigid endoscope through the mouth into the esophagus and advances a balloon through the scope. The balloon is then expanded to less than 30 mm to dilate a narrowed segment of the esophagus.
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Service type: Endoscopic esophageal balloon dilation
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Typical site of service: Ambulatory surgical center or hospital outpatient department; procedure is performed via the oral route into the esophagus.