Streamlined Reimbursement Advances U.S. Access to Organ-Sparing GI Procedure
TOKYO and CENTER VALLEY, Pa. , Nov. 12, 2026 /PRNewswire/ — Olympus Corporation, a global MedTech company committed to advancing endoscopy-enabled care, announced today publication of final valuations and CY2027 Medicare reimbursement rates for the Endoscopic Submucosal Dissection (ESD) Category I Current Procedural Terminology (CPT®) codes by the U.S. Centers for Medicare & Medicaid Services (CMS). The rates and new codes take effect Jan. 1, 2027.
These newly designated ESD procedure codes allow physicians to report in all sites of service and allow outpatient facilities to separate upper and lower ESD procedures in billing and reporting. The two separate codes describe ESD procedures in the upper and lower gastrointestinal (GI) tract.
- Upper: [CPT 43498] – Endoscopic submucosal dissection (ESD) of upper gastrointestinal tract, including mucosal closure, when performed
- Lower: [CPT 45991] – Endoscopic submucosal dissection (ESD) of lower gastrointestinal tract, including mucosal closure, when performed
ESD is a minimally invasive endoscopic procedure used to treat cancerous and pre-cancerous lesions of the GI tract. The procedure allows a trained physician to remove the abnormal tissue through an endoscope, without external incisions. For select patients, this approach may offer a minimally invasive alternative to more extensive surgery to remove part or all of the affected organ, while preserving the affected organ.1,2,3
“The value of ESD for patients is that it can accomplish both diagnosis and treatment in a single, organ-preserving procedure. By removing the lesion in one piece, we can determine more accurately whether the cancer has been completely treated and, for appropriately selected patients, potentially avoid major surgery,4” said Dr. Joo Ha Hwang, M.D., Ph.D., Chief of the Division of Gastroenterology and Hepatology at Stanford University.
The final valuations reflect the clinical complexity and physician work involved in ESD. The new Category I CPT codes provide standardized coding for reporting ESD procedures in the U.S.
“Appropriate valuation is an important component of supporting patient access to ESD,” said Racho Strauven, Senior Vice President, Health Economics and Market Access at Olympus Corporation. “These rates recognize the skill and clinical expertise ESD requires. Together with standardized coding, they help address reimbursement considerations associated with establishing ESD programs. This result reflects years of collaboration with professional societies and clinical leaders who championed this procedure.”
“ESD is central to how Olympus is advancing endoscopy-enabled care, which means detecting and treating GI disease earlier and less invasively. With two new Category I CPT codes now in place, we see a clearer pathway for more patients to have access to ESD, an important organ-sparing option for the treatment of mucosal lesions,” said Keith Boettiger, Executive Officer and Head of the Gastrointestinal Solutions Division at Olympus Corporation. “Having helped pioneer ESD alongside physicians in Japan,5 we will continue to invest in professional education, hands-on training and advanced technologies that help U.S. clinicians bring this procedure to more patients.”
Visit the Olympus Americas ESD web page for more information about the ESD procedure: medical.olympusamerica.com/endoscopic-submucosal-dissection
About Olympus At Olympus, we are committed to Our Purpose of making people’s lives healthier, safer and more fulfilling. As a global medical technology company, we partner with healthcare professionals to provide solutions and services for early detection, diagnosis and minimally invasive treatment, aiming to improve patient outcomes by elevating the standard of care in targeted disease states.
For more than 100 years, Olympus has pursued a goal of contributing to society by producing products designed with the purpose of delivering optimal outcomes for its customers around the world.
Olympus Corporation of the Americas, a wholly owned subsidiary of Olympus Corporation, is headquartered in Center Valley, Pennsylvania, USA, and employs more than 4,500 employees throughout locations in North and South America. For more information, visit medical.olympusamerica.com.
¹Fukami N. Gastrointest Endosc Clin N Am. 2023;33(1):55-66
²Abdelfatah MM, et al. Eur J Gastroenterol Hepatol. 2019;31(4):418-424
³Qian M, et al. Cancers. 2022;14(15):3603
4Al-Haddad MA, Elhanafi SE, Forbes N, et al. American Society for Gastrointestinal Endoscopy guideline on endoscopic submucosal dissection for the management of early esophageal and gastric cancers: methodology and review of evidence. Gastrointest Endosc. 2023;98(3):285-305.e38. doi:10.1016/j.gie.2023.03.030
5 Takamaru H, Saito Y. Characteristics and uses of IT knife nano. Mini-invasive Surgery. 2022;6:15.
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