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CPT 43244: Endoscopic Band Ligation of Esophageal or Gastric Vessels

CPT code 43244 represents a therapeutic upper endoscopy in which a flexible endoscope is passed through the mouth into the esophagus, stomach, and duodenum and enlarged blood vessels are treated with band ligation. Nationally, this code is used to capture care for patients at risk of or actively experiencing variceal bleeding, a significant contributor to gastrointestinal hemorrhage that impacts hospital resource use and emergency care patterns. Its appropriate use affects acute care workflows and payer coverage decisions for endoscopic hemorrhage control.

Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service and typical sites of service, common billing modifiers and coding context (where available), and guidance on where to find related coding categories. The publication outlines typical clinical indications for therapeutic band ligation, operational implications for ambulatory surgery centers and hospital outpatient departments, and the coding relationships relevant to endoscopic hemostasis. Data not available in the input is noted where applicable. This resource is intended to help coding, billing, and clinical stakeholders understand the purpose and common use cases for CPT code 43244 in a national context.

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Billing Code Overview

CPT code 43244 describes an endoscopic procedure in which a flexible endoscope is inserted through the mouth into the esophagus, stomach, and duodenum and enlarged blood vessels in the esophagus or stomach are treated with band ligation by placing tiny rubber bands to tie off the vessels. This procedure is a therapeutic upper endoscopy focused on controlling or preventing bleeding from varices or other dilated vessels.

Service type: Therapeutic upper gastrointestinal endoscopy with variceal or vascular band ligation
Typical site of service: Hospital outpatient department or ambulatory surgical center; may also be performed in an endoscopy suite within a hospital setting

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CPT 43244: Endoscopic Band Ligation of Esophageal or Gastric Vessels

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Billing Code Overview

Service type: Therapeutic upper gastrointestinal endoscopy with variceal or vascular band ligation
Typical site of service: Hospital outpatient department or ambulatory surgical center; may also be performed in an endoscopy suite within a hospital setting

Clinical & Coding Specifications

Clinical Context

A 54-year-old patient with a history of cirrhosis and portal hypertension presents with acute upper gastrointestinal bleeding manifesting as hematemesis and melena. The patient is hemodynamically stabilized in the emergency department with IV fluids and blood products as needed, and after initial resuscitation is taken to the endoscopy suite for diagnostic and therapeutic upper endoscopy. Using a flexible video endoscope introduced through the mouth, the gastroenterologist inspects the esophagus, stomach, and duodenum, identifies bleeding or high-risk varices, and performs endoscopic variceal band ligation to control hemorrhage. Typical workflow includes pre-procedure assessment and consent, moderate sedation or monitored anesthesia care depending on comorbidities, the endoscopic banding procedure, post-anesthesia recovery with monitoring for rebleeding or complications, and documentation of the number and location of bands deployed. Typical site of service is the hospital endoscopy suite, operating room, or ambulatory surgical center when clinically appropriate. Service type: endoscopic therapeutic intervention (upper GI endoscopy with variceal band ligation).

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician’s professional interpretation and service separate from technical facility charges.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is started but discontinued due to extenuating circumstances or patient condition.
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure or service unrelated to other services on the same date.
`62`	Two surgeons	Use when two surgeons with different specialties work together as primary surgeons.
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure later the same day.
`77`	Repeat procedure by another physician	Use when a different physician repeats the procedure the same day.
`78`	Return to operating/procedure room for related procedure during postoperative period	Use for unplanned return to the OR/procedure room for a related procedure during global period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon is required and documented.
`AS`	New technology or ambulatory surgical center specific (Ambulatory surgery center)	Use as required by payors for ASC reporting when performed in that setting.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures where qualifying circumstances exist	Use when physician directs anesthesia care for concurrent cases (applies to anesthesia coding in the setting of monitored anesthesia care).
`QX`	CRNA service with medical direction by physician	Use when a CRNA provides anesthesia under medical direction and reporting requires this modifier.
`TC`	Technical component	Use when billing only the technical component (facility/equipment) separate from physician professional service.
`22`	Increased procedural services	Use when work or complexity substantially exceeds the typical service and documentation supports unusual effort.

Taxonomy Code	Specialty	Notes
`207RC0000X`	Gastroenterology	Most common specialty performing upper endoscopy with variceal band ligation.
`2080P0222X`	General Surgery	Surgeons with advanced endoscopy training may perform therapeutic endoscopy in operative settings.
`207RH0000X`	Hepatology	Hepatologists frequently manage portal hypertension and may perform or coordinate banding procedures.
`363LF0000X`	Anesthesiology	Provides monitored anesthesia care or general anesthesia when indicated.
`208000000X`	Colorectal Surgery	Occasionally involved in complex GI bleeding cases requiring surgical coordination.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I85.00`	Esophageal varices without bleeding	Indicates presence of varices that may require elective banding to prevent bleeding.
`I85.01`	Esophageal varices with bleeding	Primary indication for urgent endoscopic band ligation to control active hemorrhage.
`I86.4`	Gastric varices	Varices in the stomach that may require endoscopic therapy, including banding or other modalities.
`K76.6`	Portal hypertension	Underlying condition that predisposes to development of gastroesophageal varices.
`K74.60`	Unspecified cirrhosis of liver	Cirrhosis is the most common cause of portal hypertension and variceal formation.
`R04.0`	Epistaxis (nasal hemorrhage)	Note: Not directly related; exclude.
`R04.8`	Hemorrhage from other sites in the respiratory tract	Note: Not directly related; exclude.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`43235`	Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)	Diagnostic EGD often precedes therapeutic band ligation when initial endoscopic evaluation is done without therapy.
`43760`	Ligation of esophageal varices, by endoscopic methods (band ligation technique) [Note: used historically; use `43244` per current coding]	Related therapeutic code historically used for variceal ligation; documents alternative coding for similar therapy.
`00740`	Anesthesia for upper abdominal procedures (upper GI endoscopy)	Anesthesia services or monitored anesthesia care may be billed separately when provided for this procedure.
`99152`	Moderate sedation services provided by the same physician performing the procedure (initial 15 minutes)	Used when moderate sedation is reported by the same physician performing the endoscopic intervention, if payor allows.
`43239`	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	Biopsies may be performed during the same session for diagnostic evaluation and are reported with this code when applicable.
`43255`	Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method	Alternative or adjunct code for endoscopic hemostasis procedures when multiple methods are used during the session.

CPT 43210: EGD with Complete or Partial Fundoplication

CPT-43235-DIAGNOSTIC-ESOPHAGOGASTRODUODENOSCOPY-EGD

CPT 43235: Diagnostic Esophagogastroduodenoscopy (EGD)

CPT-43236-UPPER-ENDOSCOPY-SUBMUCOSAL-INJECTION

CPT 43236: Upper Endoscopy with Submucosal Injection

CPT-43237-UPPER-ENDOSCOPY-WITH-ENDOSCOPIC-ULTRASOUND-EUS

CPT 43237: Upper Endoscopy with Endoscopic Ultrasound (EUS)

CPT-43238-ENDOSCOPIC-ULTRASOUND-FNA-BIOPSY-UPPER-GI

CPT 43238: Endoscopic Ultrasound with FNA/Biopsy of Upper GI

CPT-43239-ESOPHAGOGASTRODUODENOSCOPY-WITH-BIOPSY

CPT 43239: Esophagogastroduodenoscopy with Biopsy

CPT-43240-ENDOSCOPIC-PSEUDOCYST-DRAINAGE-STENT-PLACEMENT

CPT 43240: Endoscopic Pseudocyst Drainage with Stent Placement

CPT-43241-UPPER-ENDOSCOPY-WITH-TUBE-OR-CATHETER-PLACEMENT

CPT 43241: Upper Endoscopy with Tube or Catheter Placement

CPT-43242-EUS-GUIDED-FNA-BIOPSY-UPPER-GI

CPT 43242: EUS-Guided Fine Needle Aspiration/Biopsy of Upper GI

CPT-43243-ENDOSCOPIC-SCLEROTHERAPY-ESOPHAGUS-STOMACH

CPT 43243: Endoscopic Sclerotherapy for Esophageal or Gastric Varices

Showing 1–10 of 25

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician’s professional interpretation and service separate from technical facility charges.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is started but discontinued due to extenuating circumstances or patient condition.
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure or service unrelated to other services on the same date.
`62`	Two surgeons	Use when two surgeons with different specialties work together as primary surgeons.
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure later the same day.
`77`	Repeat procedure by another physician	Use when a different physician repeats the procedure the same day.
`78`	Return to operating/procedure room for related procedure during postoperative period	Use for unplanned return to the OR/procedure room for a related procedure during global period.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon is required and documented.
`AS`	New technology or ambulatory surgical center specific (Ambulatory surgery center)	Use as required by payors for ASC reporting when performed in that setting.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures where qualifying circumstances exist	Use when physician directs anesthesia care for concurrent cases (applies to anesthesia coding in the setting of monitored anesthesia care).
`QX`	CRNA service with medical direction by physician	Use when a CRNA provides anesthesia under medical direction and reporting requires this modifier.
`TC`	Technical component	Use when billing only the technical component (facility/equipment) separate from physician professional service.
`22`	Increased procedural services	Use when work or complexity substantially exceeds the typical service and documentation supports unusual effort.

Taxonomy Code	Specialty	Notes
`207RC0000X`	Gastroenterology	Most common specialty performing upper endoscopy with variceal band ligation.
`2080P0222X`	General Surgery	Surgeons with advanced endoscopy training may perform therapeutic endoscopy in operative settings.
`207RH0000X`	Hepatology	Hepatologists frequently manage portal hypertension and may perform or coordinate banding procedures.
`363LF0000X`	Anesthesiology	Provides monitored anesthesia care or general anesthesia when indicated.
`208000000X`	Colorectal Surgery	Occasionally involved in complex GI bleeding cases requiring surgical coordination.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I85.00`	Esophageal varices without bleeding	Indicates presence of varices that may require elective banding to prevent bleeding.
`I85.01`	Esophageal varices with bleeding	Primary indication for urgent endoscopic band ligation to control active hemorrhage.
`I86.4`	Gastric varices	Varices in the stomach that may require endoscopic therapy, including banding or other modalities.
`K76.6`	Portal hypertension	Underlying condition that predisposes to development of gastroesophageal varices.
`K74.60`	Unspecified cirrhosis of liver	Cirrhosis is the most common cause of portal hypertension and variceal formation.
`R04.0`	Epistaxis (nasal hemorrhage)	Note: Not directly related; exclude.
`R04.8`	Hemorrhage from other sites in the respiratory tract	Note: Not directly related; exclude.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`43235`	Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)	Diagnostic EGD often precedes therapeutic band ligation when initial endoscopic evaluation is done without therapy.
`43760`	Ligation of esophageal varices, by endoscopic methods (band ligation technique) [Note: used historically; use `43244` per current coding]	Related therapeutic code historically used for variceal ligation; documents alternative coding for similar therapy.
`00740`	Anesthesia for upper abdominal procedures (upper GI endoscopy)	Anesthesia services or monitored anesthesia care may be billed separately when provided for this procedure.
`99152`	Moderate sedation services provided by the same physician performing the procedure (initial 15 minutes)	Used when moderate sedation is reported by the same physician performing the endoscopic intervention, if payor allows.
`43239`	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	Biopsies may be performed during the same session for diagnostic evaluation and are reported with this code when applicable.
`43255`	Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method	Alternative or adjunct code for endoscopic hemostasis procedures when multiple methods are used during the session.

CPT 43210: EGD with Complete or Partial Fundoplication

CPT-43235-DIAGNOSTIC-ESOPHAGOGASTRODUODENOSCOPY-EGD

CPT 43235: Diagnostic Esophagogastroduodenoscopy (EGD)

CPT-43236-UPPER-ENDOSCOPY-SUBMUCOSAL-INJECTION

CPT 43236: Upper Endoscopy with Submucosal Injection

CPT-43237-UPPER-ENDOSCOPY-WITH-ENDOSCOPIC-ULTRASOUND-EUS

CPT 43237: Upper Endoscopy with Endoscopic Ultrasound (EUS)

CPT-43238-ENDOSCOPIC-ULTRASOUND-FNA-BIOPSY-UPPER-GI

CPT 43238: Endoscopic Ultrasound with FNA/Biopsy of Upper GI

CPT-43239-ESOPHAGOGASTRODUODENOSCOPY-WITH-BIOPSY

CPT 43239: Esophagogastroduodenoscopy with Biopsy

CPT-43240-ENDOSCOPIC-PSEUDOCYST-DRAINAGE-STENT-PLACEMENT

CPT 43240: Endoscopic Pseudocyst Drainage with Stent Placement

CPT-43241-UPPER-ENDOSCOPY-WITH-TUBE-OR-CATHETER-PLACEMENT

CPT 43241: Upper Endoscopy with Tube or Catheter Placement

CPT-43242-EUS-GUIDED-FNA-BIOPSY-UPPER-GI

CPT 43242: EUS-Guided Fine Needle Aspiration/Biopsy of Upper GI

CPT-43243-ENDOSCOPIC-SCLEROTHERAPY-ESOPHAGUS-STOMACH

CPT 43243: Endoscopic Sclerotherapy for Esophageal or Gastric Varices

Showing 1–10 of 25

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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CPT 43244: Endoscopic Band Ligation of Esophageal or Gastric Vessels

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Billing Code Overview

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CPT 43244: Endoscopic Band Ligation of Esophageal or Gastric Vessels

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 43244: Endoscopic Band Ligation of Esophageal or Gastric Vessels

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Billing Code Overview

CPT 43244: Endoscopic Band Ligation of Esophageal or Gastric Vessels

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical service does CPT 43244 represent and where is it typically performed?

Which related CPT codes or sedation/anesthesia codes are commonly reported with 43244?

What ICD-10 diagnoses are most commonly associated with billing CPT 43244?

Which billing modifiers are relevant for reporting 43244 and when are they used?

Which specialties and taxonomy codes are associated with performing endoscopic variceal band ligation (43244)?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical service does CPT 43244 represent and where is it typically performed?

Which related CPT codes or sedation/anesthesia codes are commonly reported with 43244?

What ICD-10 diagnoses are most commonly associated with billing CPT 43244?

Which billing modifiers are relevant for reporting 43244 and when are they used?

Which specialties and taxonomy codes are associated with performing endoscopic variceal band ligation (43244)?

References