Average Medicaid Upper Endoscopy (EGD) Payments in Buffalo, NY: $617.39
Avg. Paid
$617.39
Range
$92.80 – $1,978
Total Claims
4,132
Providers
12
Typical Payment Range
Typical Medicaid Upper Endoscopy (EGD) payments fall between $76.12 and $225.09 per claim (median: $127.97). The top 10% of payments exceed $381.16.
Based on per-provider averages across all Medicaid claims in this category.
Upper endoscopy examines the lining of the esophagus, stomach, and first part of the small intestine using a thin, flexible tube with a camera.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Upper Endoscopy (EGD) in Buffalo, NY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Kaleida Health
100 High St |
$645.67 | 1,279 | 1,268 |
|
Erie County Medical Center Corporation
462 Grider St |
$658.08 | 853 | 850 |
|
Kaleida Health
818 Ellicott St |
$643.97 | 698 | 698 |
|
Sisters Of Charity Hospital Of Buffalo New York
2157 Main St |
$702.49 | 457 | 457 |
|
Kaleida Health
100 High St |
$719.32 | 454 | 453 |
|
Osama Farouq Almadhoun
1001 Main St Fl 4 |
$110.22 | 263 | 263 |
|
Kenneth Schmidt
1001 Main St Fl 5 |
$140.84 | 28 | 28 |
|
Thomas Mahl
3495 Bailey Ave |
$92.80 | 25 | 24 |
|
Brian M Edelstein
1001 Main St Fl 4 |
$124.15 | 24 | 24 |
|
Susan Sestini Baker
219 Bryant St |
$119.56 | 20 | 20 |
|
Robert Denio Baker
219 Bryant Street |
$128.70 | 19 | 19 |
|
Roswell Park Cancer Institute
Elm And Carlton St |
$1,978 | 12 | 12 |
What to Expect: Upper Endoscopy (EGD)
An upper endoscopy takes 15-30 minutes. You'll be sedated. A thin flexible tube with a camera is passed through your mouth into your esophagus, stomach, and duodenum. Biopsies may be taken. You'll need someone to drive you home afterward. Most people can eat a few hours after the procedure. Mild throat soreness is common for a day or two.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 43239 | EGD w/biopsy upper GI | $253.86 | 5,956,836 | 9,455 |
| 43235 | EGD diagnostic upper GI | $254.50 | 202,728 | 958 |
| 43248 | EGD w/dilation guide wire | $140.00 | 59,963 | 186 |
| 43249 | EGD w/balloon dilation | $350.47 | 27,932 | 155 |
| 43251 | EGD w/snare removal | $247.77 | 8,994 | 30 |
| 43255 | EGD w/control bleeding | $475.08 | 7,407 | 9 |
| 43246 | EGD w/PEG tube placement | $137.82 | 3,019 | 30 |
| 43237 | EGD w/endoscopic us | $308.70 | 2,887 | 33 |
| 43250 | EGD w/tumor removal | $258.39 | 2,380 | 11 |
| 43244 | EGD w/band ligation | $253.62 | 1,697 | 25 |
| 43236 | EGD w/submucosal injection | $37.02 | 1,037 | 6 |
| 43245 | EGD w/dilation stricture | $91.88 | 1,020 | 10 |
| 43247 | EGD w/foreign body removal | $93.65 | 915 | 11 |
| 43252 | EGD w/optical endomicroscopy | $166.89 | 722 | 10 |
| 43254 | EGD w/endo mucosal resection | $164.97 | 472 | 2 |
| 43242 | EGD w/us guided inj/asp | $234.58 | 258 | 9 |
| 43253 | EGD w/injection sclerosis | $179.99 | 161 | 4 |
| 43238 | EGD w/us guided needle bx | $618.60 | 13 | 1 |
| 43241 | EGD w/tube/catheter | $91.14 | 13 | 1 |
| 43240 | EGD w/drainage pseudocyst | — | — | — |
| 43243 | EGD w/injection varices | — | — | — |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Upper Endoscopy (EGD) cost in Buffalo, NY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in Buffalo, NY is $617.39 per claim, based on 4,132 claims from 12 providers. Typical payments fall between $76.12 and $225.09. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Upper Endoscopy (EGD) in Buffalo, NY?
There are 12 Medicaid providers offering Upper Endoscopy (EGD) related services in Buffalo, NY according to public payment data.
What is the price range for Upper Endoscopy (EGD) in Buffalo, NY?
Medicaid reimbursement for Upper Endoscopy (EGD) in Buffalo, NY ranges from $92.80 to $1,978 per claim, with an average of $617.39. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Upper Endoscopy (EGD) in Other Cities
Brooklyn, NY
Avg $322.26
138,581 claims · 113 providers
New York, NY
Avg $375.46
133,047 claims · 106 providers
Flushing, NY
Avg $306.22
93,103 claims · 35 providers
Phoenix, AZ
Avg $302.49
71,548 claims · 71 providers
Bakersfield, CA
Avg $392.48
66,129 claims · 26 providers
Los Angeles, CA
Avg $140.58
60,228 claims · 72 providers
Tucson, AZ
Avg $288.42
55,967 claims · 58 providers
Detroit, MI
Avg $206.86
50,758 claims · 16 providers
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