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Code deleted, see 43214 43233

Official Description

Dilation of esophagus with balloon (30 mm diameter or larger) for achalasia

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 43458 involves the dilation of the esophagus using a balloon that has a diameter of 30 mm or larger, specifically aimed at treating achalasia. Achalasia is a disorder characterized by the inability of the esophageal sphincter muscles to relax, which leads to a blockage that prevents food and liquids from passing into the stomach. This condition can cause significant discomfort and difficulty swallowing. During the procedure, a balloon catheter is introduced through the mouth and navigated into the esophagus. Once in place, the balloon is inflated to widen the esophagus, thereby alleviating the obstruction caused by the spasming sphincter muscles. The inflation of the balloon is typically maintained for a brief duration, ranging from 30 seconds to 2 minutes, before it is deflated and removed. This intervention is performed under fluoroscopic guidance, which is a real-time imaging technique that allows the physician to visualize the esophagus and ensure proper placement and effectiveness of the dilation. The goal of this procedure is to improve the patient's ability to swallow and enhance their quality of life by relieving the symptoms associated with achalasia.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure is indicated for patients diagnosed with achalasia, a condition that results in the esophageal sphincter muscles being unable to relax, leading to a blockage in the esophagus. The following are specific indications for performing balloon dilation:

  • Achalasia A condition characterized by the failure of the lower esophageal sphincter to relax, causing difficulty in swallowing and obstruction of food passage.

2. Procedure

The procedure for balloon dilation of the esophagus is carried out as follows:

  • Step 1: Preparation The patient is positioned appropriately, and sedation may be administered to ensure comfort during the procedure. The physician prepares the necessary equipment, including the balloon catheter and fluoroscopic imaging system.
  • Step 2: Insertion of the Balloon Catheter The physician carefully passes the balloon catheter through the patient's mouth and into the esophagus. This step requires precision to ensure that the catheter is correctly positioned at the site of the esophageal obstruction.
  • Step 3: Dilation Once the balloon is in place, it is inflated with a controlled amount of fluid or air. The inflation is maintained for a duration of 30 seconds to 2 minutes, allowing the balloon to exert pressure on the esophageal walls, thereby dilating the sphincter and alleviating the blockage.
  • Step 4: Deflation and Removal After the dilation period, the balloon is deflated and carefully removed from the esophagus. The physician monitors the patient for any immediate complications during this process.
  • Step 5: Post-Procedure Assessment Following the removal of the balloon, the physician may conduct a brief assessment to evaluate the effectiveness of the dilation and ensure that the patient is stable before concluding the procedure.

3. Post-Procedure

After the balloon dilation procedure, patients are typically monitored for a short period to assess for any immediate complications or adverse reactions. It is common for patients to experience some discomfort or a sensation of fullness in the esophagus following the procedure. Recovery time may vary, but many patients can resume normal activities within a day. Physicians may provide specific post-procedure care instructions, including dietary modifications and follow-up appointments to monitor the patient's progress and evaluate the effectiveness of the treatment. It is essential for patients to report any unusual symptoms, such as severe pain or difficulty swallowing, to their healthcare provider promptly.

Short Descr DILATE ESOPHAGUS
Medium Descr DILAT ESOPH BALLOON 30 MM DIAM/> ACHALASIA
Long Descr Dilation of esophagus with balloon (30 mm diameter or larger) for achalasia
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE Not applicable/unspecified.
CCS Clinical Classification 69 - Esophageal dilatation
Date
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Notes
2014-01-01 Deleted Code deleted, see 43214 43233
1994-01-01 Added Code added.
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