Average Medicaid Upper Endoscopy (EGD) Payments in Menomonee Falls, WI: $156.13
Avg. Paid
$156.13
Range
$105.21 – $176.83
Total Claims
174
Providers
4
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 Menomonee Falls, WI
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Community Memorial Hospital Of Menomonee Falls Inc
W180N8085 Town Hall Rd |
$176.83 | 75 | 66 |
|
Shaibal Mazumdar
N84W16889 Menomonee Ave |
$156.21 | 54 | 53 |
|
Menomonee Falls Ambulatory Surgery Center, Llc
W180N8045 Town Hall Rd |
$105.21 | 30 | 29 |
|
Syed Mehdi
W129N7055 Northfield Dr |
$154.18 | 15 | 13 |
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 Menomonee Falls, WI?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in Menomonee Falls, WI is $156.13 per claim, based on 174 claims from 4 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 Menomonee Falls, WI?
There are 4 Medicaid providers offering Upper Endoscopy (EGD) related services in Menomonee Falls, WI according to public payment data.
What is the price range for Upper Endoscopy (EGD) in Menomonee Falls, WI?
Medicaid reimbursement for Upper Endoscopy (EGD) in Menomonee Falls, WI ranges from $105.21 to $176.83 per claim, with an average of $156.13. 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
Other Procedures in Menomonee Falls, WI
Blood Work & Lab Tests
Avg $10.38
161,439 claims
Emergency Room Visit
Avg $53.39
119,875 claims
Office Visit
Avg $34.92
98,190 claims
Personal Care Services
Avg $11.90
57,871 claims
Physical Therapy
Avg $15.38
54,799 claims
X-Ray
Avg $7.13
53,325 claims
Urinalysis & Urine Tests
Avg $5.24
46,046 claims
EKG / ECG (Electrocardiogram)
Avg $4.75
38,694 claims