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CPT 43450: Esophageal Dilation for Stricture

CPT code 43450 denotes esophageal dilation using progressively larger tubular dilators to widen an esophageal stricture and improve swallowing. This therapeutic endoscopic procedure is commonly performed in ambulatory surgery centers, hospital outpatient departments, and dedicated endoscopy suites. Nationally, esophageal dilation is a frequently used intervention for dysphagia caused by benign or malignant strictures, and correct coding affects claims processing, site-of-service reporting, and aggregate utilization tracking.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and payer coverage landscape. The publication summarizes benchmark metrics where available, highlights recent policy considerations affecting endoscopic therapeutic procedures, and provides coding context to support accurate claim submission and interpretation of utilization patterns.

This report is intended for billing professionals, revenue cycle managers, clinicians involved in gastrointestinal procedures, and policy analysts who need a practical reference on CPT code 43450, its clinical purpose, and the payer environment relevant to esophageal dilation services.

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Billing Code Overview

CPT code 43450 describes the passage of long, thin tubular devices of increasing diameter to dilate, or widen, a stricture in the patient’s esophagus to improve swallowing. This procedure is an esophageal dilation intended to relieve obstructive symptoms caused by a narrowing of the esophagus.

Service type: Therapeutic endoscopic procedure (esophageal dilation)
Typical site of service: Ambulatory surgery center, hospital outpatient department, or endoscopy suite where endoscopic therapeutic procedures are performed.

Data not available in the input.

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CPT 43450: Esophageal Dilation for Stricture

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Billing Code Overview

Service type: Therapeutic endoscopic procedure (esophageal dilation)
Typical site of service: Ambulatory surgery center, hospital outpatient department, or endoscopy suite where endoscopic therapeutic procedures are performed.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 62-year-old male with progressive dysphagia to solids and intermittent regurgitation is referred to gastroenterology after barium swallow suggests a short-segment esophageal stricture at the distal esophagus. The patient has a history of chronic gastroesophageal reflux disease and prior radiation for head and neck cancer. After pre-procedure evaluation and informed consent, the patient undergoes outpatient endoscopic esophageal dilation using graduated bougie dilators under monitored anesthesia care. The clinical workflow includes pre-procedure assessment (history, medication reconciliation, NPO status), informed consent, procedural sedation by anesthesia or monitored anesthesia care, placement of progressively larger long thin tubular dilators to widen the stricture, immediate post-procedure assessment for complications (bleeding, perforation), and disposition with post-procedure instructions and follow-up to assess symptom improvement and need for repeat dilation.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure	Use when a same-day E/M visit is medically necessary and documented separately from the dilation encounter.
`26`	Professional component	Use when reporting only the physician professional portion of a service if the facility bills the technical component separately.
`52`	Reduced service	Use when the dilation is partially reduced or not completed as originally planned for documented clinical reasons.
`53`	Discontinued procedure	Use when the dilation is started but terminated due to an unforeseen complication or patient condition.
`59`	Distinct procedural service	Use to indicate a separate and distinct procedure on the same day when bundling edits might apply.
`62`	Two surgeons	Use when two surgeons with distinct roles are required and documented for the procedure.
`76`	Repeat procedure by same physician (note: not in provided list)	Data not available in the input.
`73`	Discontinued outpatient procedure prior to anesthesia start	Use when the outpatient dilation is canceled after preparation but before anesthesia induction.
`78`	Unplanned return to operating/procedure room for a related procedure during the postoperative period	Use when the patient requires return to procedure room for a complication of the original dilation.
`79`	Unrelated procedure or service by the same physician during postoperative period	Use when an unrelated procedure is performed during the global period.
`22`	Increased procedural services	Use when the dilation required substantially greater effort or complexity than typical and documentation supports increased work.
`50`	Bilateral procedure	Not typically applicable to esophageal dilation; include only if documentation supports bilateral distinct procedures (rare).
`59`	Distinct procedural service	Duplicate entry removed in final billing; see above.

Taxonomy Code	Specialty	Notes
`207RE0200X`	Gastroenterology	Gastroenterologists most commonly perform endoscopic esophageal dilations.
`208800000X`	General Surgery	General surgeons with foregut expertise perform dilations in operative settings.
`2084P0800X`	Thoracic Surgery	Thoracic surgeons may perform dilations for complex strictures or surgical planning.
`2080S0122X`	Otolaryngology (ENT)	ENT specialists perform dilations for proximal esophageal or hypopharyngeal strictures.
`207K00000X`	Pulmonology	Pulmonologists may be involved when airway-esophageal considerations exist.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K22.2`	Stricture and stenosis of esophagus	Direct indication for esophageal dilation to relieve luminal narrowing and improve swallowing.
`K21.0`	Gastro-esophageal reflux disease with esophagitis	Reflux-related injury can lead to peptic strictures treated with dilation.
`C15.9`	Malignant neoplasm of esophagus, unspecified	Malignant strictures may require dilation for palliation of dysphagia.
`T81.2`	Accidental puncture and laceration during a procedure, not elsewhere classified	Listed as a potential procedural complication to monitor for post-dilation.
`R13.10`	Dysphagia, unspecified	Symptom leading to diagnostic evaluation and potential dilation when a mechanical obstruction is identified.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`43235`	Esophagogastroduodenoscopy, flexible, transoral; diagnostic, with or without collection of specimen(s) by brushing or washing	Often performed immediately before dilation to evaluate the stricture and guide dilation strategy.
`43456`	Dilation of esophagus over guidewire, under fluoroscopic guidance	Alternative or adjunct dilation technique when fluoroscopic guidance or guidewire-assisted dilation is required.
`43239`	Esophagoscopy, rigid or flexible; with biopsy, single or multiple	May be performed if biopsy of a stricture or suspicious lesion is needed during the same encounter.
`43249`	Esophagoscopy, flexible, transoral; with foreign body removal, without anesthesia provider	Performed when food impaction or foreign body is present and requires removal before or during dilation.
`76937`	Ultrasound guidance for vascular access and/or for procedural guidance (used as an example)	Data not available in the input.

CPT 43453: Esophageal Dilation Over Guide Wire, Therapeutic

CPT-43460-ESOPHAGEAL-BALLOON-COMPRESSION-FOR-BLEEDING

CPT 43460: Endoscopic Balloon Compression for Esophageal Bleeding

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure	Use when a same-day E/M visit is medically necessary and documented separately from the dilation encounter.
`26`	Professional component	Use when reporting only the physician professional portion of a service if the facility bills the technical component separately.
`52`	Reduced service	Use when the dilation is partially reduced or not completed as originally planned for documented clinical reasons.
`53`	Discontinued procedure	Use when the dilation is started but terminated due to an unforeseen complication or patient condition.
`59`	Distinct procedural service	Use to indicate a separate and distinct procedure on the same day when bundling edits might apply.
`62`	Two surgeons	Use when two surgeons with distinct roles are required and documented for the procedure.
`76`	Repeat procedure by same physician (note: not in provided list)	Data not available in the input.
`73`	Discontinued outpatient procedure prior to anesthesia start	Use when the outpatient dilation is canceled after preparation but before anesthesia induction.
`78`	Unplanned return to operating/procedure room for a related procedure during the postoperative period	Use when the patient requires return to procedure room for a complication of the original dilation.
`79`	Unrelated procedure or service by the same physician during postoperative period	Use when an unrelated procedure is performed during the global period.
`22`	Increased procedural services	Use when the dilation required substantially greater effort or complexity than typical and documentation supports increased work.
`50`	Bilateral procedure	Not typically applicable to esophageal dilation; include only if documentation supports bilateral distinct procedures (rare).
`59`	Distinct procedural service	Duplicate entry removed in final billing; see above.

Taxonomy Code	Specialty	Notes
`207RE0200X`	Gastroenterology	Gastroenterologists most commonly perform endoscopic esophageal dilations.
`208800000X`	General Surgery	General surgeons with foregut expertise perform dilations in operative settings.
`2084P0800X`	Thoracic Surgery	Thoracic surgeons may perform dilations for complex strictures or surgical planning.
`2080S0122X`	Otolaryngology (ENT)	ENT specialists perform dilations for proximal esophageal or hypopharyngeal strictures.
`207K00000X`	Pulmonology	Pulmonologists may be involved when airway-esophageal considerations exist.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K22.2`	Stricture and stenosis of esophagus	Direct indication for esophageal dilation to relieve luminal narrowing and improve swallowing.
`K21.0`	Gastro-esophageal reflux disease with esophagitis	Reflux-related injury can lead to peptic strictures treated with dilation.
`C15.9`	Malignant neoplasm of esophagus, unspecified	Malignant strictures may require dilation for palliation of dysphagia.
`T81.2`	Accidental puncture and laceration during a procedure, not elsewhere classified	Listed as a potential procedural complication to monitor for post-dilation.
`R13.10`	Dysphagia, unspecified	Symptom leading to diagnostic evaluation and potential dilation when a mechanical obstruction is identified.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`43235`	Esophagogastroduodenoscopy, flexible, transoral; diagnostic, with or without collection of specimen(s) by brushing or washing	Often performed immediately before dilation to evaluate the stricture and guide dilation strategy.
`43456`	Dilation of esophagus over guidewire, under fluoroscopic guidance	Alternative or adjunct dilation technique when fluoroscopic guidance or guidewire-assisted dilation is required.
`43239`	Esophagoscopy, rigid or flexible; with biopsy, single or multiple	May be performed if biopsy of a stricture or suspicious lesion is needed during the same encounter.
`43249`	Esophagoscopy, flexible, transoral; with foreign body removal, without anesthesia provider	Performed when food impaction or foreign body is present and requires removal before or during dilation.
`76937`	Ultrasound guidance for vascular access and/or for procedural guidance (used as an example)	Data not available in the input.

CPT 43453: Esophageal Dilation Over Guide Wire, Therapeutic

CPT-43460-ESOPHAGEAL-BALLOON-COMPRESSION-FOR-BLEEDING

CPT 43460: Endoscopic Balloon Compression for Esophageal Bleeding

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 43450: Esophageal Dilation for Stricture

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Billing Code Overview

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CPT 43450: Esophageal Dilation for Stricture

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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 43450: Esophageal Dilation for Stricture

Sign up for cpt 43450 policy alerts

Billing Code Overview

CPT 43450: Esophageal Dilation for Stricture

Sign up for cpt 43450 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 43450 represent and where is it typically performed?

Which modifiers are commonly relevant to billing CPT 43450?

Are there other CPT codes commonly reported alongside or instead of 43450?

What diagnosis codes are typically associated with esophageal dilation using CPT 43450?

Which specialties are commonly associated with performing CPT 43450?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 43450 represent and where is it typically performed?

Which modifiers are commonly relevant to billing CPT 43450?

Are there other CPT codes commonly reported alongside or instead of 43450?

What diagnosis codes are typically associated with esophageal dilation using CPT 43450?

Which specialties are commonly associated with performing CPT 43450?

References