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BETA v.3.0

2025 CPT code 43453

Dilation of esophagus, over guide wire.

Do not report radiological guidance separately if it is included in the code description. Do not report 43453 if endoscopic visualization was used (see 43195, 43226).

Modifiers may be applicable. Refer to current CPT guidelines for appropriate usage.

Medical necessity for 43453 must be supported by documentation of a clinically significant esophageal stricture causing symptoms such as dysphagia, odynophagia (painful swallowing), or food impaction.The documentation should demonstrate that the dilation is necessary to improve the patient's ability to swallow and maintain adequate nutrition.

The physician is responsible for performing the esophageal dilation procedure, including prepping and anesthetizing the patient, passing the guide wire and dilators, and monitoring the patient throughout the process.They must also ensure appropriate documentation of the procedure.

IMPORTANT:For dilation with endoscopic visualization, see 43195, 43226. For dilation of esophagus, by balloon or dilator, see 43214, 43220, 43233, 43249. For radiological supervision and interpretation, use 74360. For endoscopic dilation of esophagus with balloon less than 30 mm diameter, see 43195, 43220, 43249. For endoscopic dilation of esophagus with balloon 30 mm diameter or larger, see 43214, 43233.For associated esophagogram, use 74220.

In simple words: This procedure helps widen a narrowed part of your food pipe (esophagus) to make swallowing easier. The doctor uses a thin wire and small tools to gently stretch the narrowed area.

This code describes a procedure where the physician dilates the esophagus using dilators over a guide wire.This is typically done to widen a narrowed area of the esophagus (a stricture) and improve the patient's ability to swallow.The procedure is performed with the patient lying supine, often under fluoroscopic guidance. It does not include endoscopic visualization.

Example 1: A patient with a history of esophageal stricture due to reflux presents with dysphagia (difficulty swallowing).The physician performs esophageal dilation over a guide wire (43453) to widen the narrowed area., A patient who has undergone radiation therapy for esophageal cancer develops a stricture.The physician performs dilation over a guide wire (43453) to alleviate the dysphagia., A patient with eosinophilic esophagitis experiences difficulty swallowing. Esophageal dilation over a guide wire (43453) is performed to improve food passage.

Documentation should include the reason for the dilation (e.g., stricture, dysphagia), the location and characteristics of the stricture, the size and type of dilators used, whether fluoroscopic guidance was used, any complications encountered, and the patient's response to the procedure. Pre- and post-procedure assessments of the patient's swallowing ability should also be documented.

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