2025 CPT code 43201

Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance.

When bleeding occurs as a result of an endoscopic procedure, control of bleeding is not reported separately during the same operative session. Esophagoscopy includes examination from the cricopharyngeus muscle (upper esophageal sphincter) to and including the gastroesophageal junction. It may also include examination of the proximal region of the stomach via retroflexion when performed.

Modifiers may be applicable to 43201 in certain situations.For example, modifier 51 (Multiple Procedures) may be used if another procedure is performed during the same session.

Medical necessity for 43201 is established by the presence of a medical condition requiring directed submucosal injection(s) in the esophagus, such as achalasia, esophageal stricture, or a suspicious lesion requiring marking or lifting for resection.

When the patient is appropriately prepped and anesthetized, the provider inserts a flexible endoscope into the mouth. The provider maneuvers the lighted endoscope into the esophagus. The provider inspects the area using the endoscope and then performs one or more submucosal injections of any substance, typically using a needle–tipped catheter inserted through the scope. Examples of substances include botulinum toxin, steroids, India ink to mark a lesion for surgical removal, and saline to lift a lesion for easier removal. The provider removes all instruments.

• Digestive System