Average Medicaid Upper Endoscopy (EGD) Payments in San Jose, CA: $174.37
Avg. Paid
$174.37
Range
$1.80 – $340.63
Total Claims
11,784
Providers
25
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 San Jose, CA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Montpelier Surgery Center Llc
2340 Montpelier Dr |
$331.44 | 3,633 | 3,623 |
|
County Of Santa Clara
751 S. Bascom Avenue |
$1.80 | 2,620 | 2,583 |
|
Physicians Surgery Services Llc
235 Oconnor Dr |
$269.62 | 2,054 | 2,031 |
|
Jenny Daci Yang
2331 Montpelier Dr Ste B |
$13.33 | 666 | 662 |
|
Forest Ambulatory Surgical Associates Llc
2110 Forest Ave Fl 2 |
$340.63 | 544 | 542 |
|
Hoan Van Tran
200 Jose Figueres Ave Ste 355 |
$105.72 | 446 | 443 |
|
Jason E Williams
751 S Bascom Ave |
$26.64 | 409 | 408 |
|
Alvaro Daniel Davila
751 S Bascom Ave |
$30.77 | 241 | 238 |
|
Eugenie Shieh
2331 Montpelier Dr Ste B |
$13.24 | 231 | 229 |
|
Khanh Kim Nguyen
2331 Montpelier Dr Ste B |
$20.09 | 176 | 174 |
|
Huy Anh Nguyen
2331 Montpelier Dr Ste B |
$22.80 | 130 | 129 |
|
Hashem M Farr
2375 Forest Ave |
$29.07 | 110 | 109 |
|
Nimeesh K Shah
751 S. Bascom Avenue |
$30.88 | 92 | 92 |
|
David Lin
751 S Bascom Ave |
$54.52 | 87 | 86 |
|
Jay S Raju
2030 Forest Ave Ste 100 |
$32.48 | 67 | 67 |
|
Susan Amber Cummings
751 S Bascom Ave |
$23.38 | 40 | 40 |
|
Huy Ngoc Trinh
227 N Jackson Ave Ste 235 |
$33.90 | 39 | 39 |
|
Ruel Tan Garcia
2340 Montpelier Dr |
$21.06 | 37 | 37 |
|
Bhargava Gannavarapu
200 Jose Figueres Ave Ste 170 |
$46.69 | 37 | 37 |
|
Ranjit Singh Makar
270 International Cir Fl 2 |
$89.84 | 30 | 28 |
|
Ahmad Kamal
751 S Bascom Ave |
$20.29 | 27 | 27 |
|
Eduardo B. V. Da Silveira
2340 Montpelier Dr |
$28.80 | 27 | 26 |
|
David J Kang
2506 Samaritan Ct |
$62.00 | 17 | 13 |
|
Geeta Raman Kutty
2331 Montpelier Dr Ste B |
$5.44 | 12 | 12 |
|
Morgan Wong
2331 Montpelier Dr Ste B |
$2.65 | 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 San Jose, CA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Upper Endoscopy (EGD) in San Jose, CA is $174.37 per claim, based on 11,784 claims from 25 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 San Jose, CA?
There are 25 Medicaid providers offering Upper Endoscopy (EGD) related services in San Jose, CA according to public payment data.
What is the price range for Upper Endoscopy (EGD) in San Jose, CA?
Medicaid reimbursement for Upper Endoscopy (EGD) in San Jose, CA ranges from $1.80 to $340.63 per claim, with an average of $174.37. 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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