Average Medicaid Upper Endoscopy (EGD) Payments in Rochester, NY: $657.66
Avg. Paid
$657.66
Range
$96.81 – $796.49
Total Claims
10,794
Providers
30
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 Rochester, NY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Patrick Twohig
601 Elmwood Ave. |
$116.38 | 12 | 12 |
|
Karin Dunnigan
800 Carter St Fl 2 |
$118.74 | 12 | 12 |
|
Janice Cheong
601 Elmwood Ave |
$111.35 | 12 | 12 |
|
Jonathan Wilmot
2080 Clinton Ave S |
$114.01 | 12 | 12 |
|
Nishaben D Patel
601 Elmwood Ave |
$140.14 | 12 | 12 |
|
Andrej Strapko
2440 Ridgeway Ave |
$234.35 | 13 | 13 |
|
Rishi Gupta
995 Senator Keating Blvd |
$108.32 | 19 | 19 |
|
Maisa Ismail Abdalla
601 Elmwood Ave |
$109.18 | 24 | 24 |
|
Tanya Sahay Bruckel
601 Elmwood Ave |
$102.28 | 24 | 24 |
|
Cary M Qualia
601 Elmwood Ave |
$96.81 | 29 | 29 |
|
Asim Mushtaq
1425 Portland Ave; Wilson Building |
$108.15 | 29 | 29 |
|
Joel Mcfarland
1425 Portland Ave |
$98.15 | 38 | 38 |
|
Ajay Kumar Rana
601 Elmwood Ave |
$132.82 | 42 | 42 |
|
Alok D Gandhi
1415Portland Ave |
$118.27 | 42 | 42 |
|
Lee Fu Peng
1425 Portland Ave |
$756.83 | 47 | 46 |
|
Robert Kornfield
601 Elmwood Ave |
$179.32 | 50 | 50 |
|
Esther Nancy Prince
995 Senator Keating Blvd |
$124.89 | 52 | 52 |
|
Erik Olson
1425 Portland Ave |
$119.20 | 54 | 54 |
|
Ari Chodos
1561 Long Pond Rd |
$178.45 | 56 | 56 |
|
Marvin Singh
20 Hagen Dr Ste 330 |
$128.32 | 57 | 57 |
|
Prasadvarma Penmetsa
1561 Long Pond Rd |
$140.55 | 58 | 58 |
|
Patricia Brogan Hughes
1415 Portland Ave |
$127.60 | 81 | 81 |
|
Manish Kumar Madan
2440 Ridgeway Ave |
$268.82 | 85 | 85 |
|
Surinder Devgun
103 Canal Landing Blvd Ste 12 |
$161.63 | 111 | 110 |
|
Unity Linden Oaks Surgery Center
1065 Senator Keating Blvd |
$500.94 | 711 | 710 |
|
Highland Hospital Of Rochester
1000 South Ave |
$674.17 | 972 | 966 |
|
U Of R Neurology Department
601 Elmwood Ave |
$796.49 | 1,114 | 1,103 |
|
Rochester General Hospital
1425 Portland Ave |
$683.09 | 1,722 | 1,679 |
|
The Unity Hospital Of Rochester
1555 Long Pond Rd |
$742.19 | 1,766 | 1,764 |
|
University Of Rochester
601 Elmwood Ave |
$718.31 | 3,538 | 3,528 |
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 Rochester, NY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in Rochester, NY is $657.66 per claim, based on 10,794 claims from 30 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 Rochester, NY?
There are 30 Medicaid providers offering Upper Endoscopy (EGD) related services in Rochester, NY according to public payment data.
What is the price range for Upper Endoscopy (EGD) in Rochester, NY?
Medicaid reimbursement for Upper Endoscopy (EGD) in Rochester, NY ranges from $96.81 to $796.49 per claim, with an average of $657.66. 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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