Average Medicaid Upper Endoscopy (EGD) Payments
Typical Medicaid Upper Endoscopy (EGD) reimbursement across 2,153 cities
Avg. Medicaid Paid
$251.83
Price Range
$0.00 – $1,810
Total Claims
5.9M
Cities
2153
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.
About This Procedure
Upper endoscopy examines the lining of the esophagus, stomach, and first part of the small intestine using a thin, flexible tube with a camera.
Why do these costs look low?
These figures represent Medicaid reimbursement rates — the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.
Costs by City
| City | Avg. Paid | Min / Max | Claims | Providers |
|---|---|---|---|---|
| Dade City, FL | $106.01 | $106.01 – $106.01 | 13 | 1 |
| Chevy Chase, MD | $83.54 | $83.54 – $83.54 | 13 | 1 |
| Springfield, TN | $161.76 | $161.76 – $161.76 | 13 | 1 |
| Covington, GA | $36.93 | $36.93 – $36.93 | 13 | 1 |
| Woodstock, IL | $226.66 | $226.66 – $226.66 | 13 | 1 |
| Franklin, VA | $599.85 | $599.85 – $599.85 | 13 | 1 |
| Lake Barrington, IL | $135.04 | $135.04 – $135.04 | 13 | 1 |
| Falmouth, MA | $70.26 | $70.26 – $70.26 | 13 | 1 |
| Socorro, NM | $662.62 | $662.62 – $662.62 | 13 | 1 |
| Jamaica Plain, MA | $56.27 | $56.27 – $56.27 | 13 | 1 |
| South Euclid, OH | $280.99 | $280.99 – $280.99 | 13 | 1 |
| Hiram, GA | $195.28 | $195.28 – $195.28 | 13 | 1 |
| Fairview Park, OH | $239.41 | $239.41 – $239.41 | 13 | 1 |
| Litchfield, IL | $190.85 | $190.85 – $190.85 | 13 | 1 |
| Northville, MI | $147.31 | $147.31 – $147.31 | 13 | 1 |
| Lancaster, TX | $402.18 | $402.18 – $402.18 | 13 | 1 |
| Delmar, MD | $280.96 | $280.96 – $280.96 | 13 | 1 |
| Arrecibo, PR | $79.25 | $79.25 – $79.25 | 13 | 1 |
| Kittery, ME | $86.20 | $86.20 – $86.20 | 14 | 1 |
| Bloomington, MN | $487.10 | $487.10 – $487.10 | 14 | 1 |
| Crossville, TN | $24.46 | $24.46 – $24.46 | 14 | 1 |
| Odessa, TX | $58.95 | $58.95 – $58.95 | 14 | 1 |
| Juneau, AK | $285.49 | $285.49 – $285.49 | 14 | 1 |
| Glen Dale, WV | $272.26 | $272.26 – $272.26 | 14 | 1 |
| Marksville, LA | $77.53 | $77.53 – $77.53 | 14 | 1 |
| Tappahannock, VA | $946.31 | $946.31 – $946.31 | 14 | 1 |
| Matthews, NC | $78.84 | $78.84 – $78.84 | 14 | 1 |
| O Fallon, MO | $209.48 | $209.48 – $209.48 | 14 | 1 |
| Roslyn, NY | $95.10 | $95.10 – $95.10 | 14 | 1 |
| Fairfield, IL | $202.59 | $202.59 – $202.59 | 14 | 1 |
| Lowell, AR | $115.66 | $115.66 – $115.66 | 14 | 1 |
| Millsboro, DE | $1.03 | $1.03 – $1.03 | 14 | 1 |
| Mount Pleasant, WI | $273.89 | $273.89 – $273.89 | 14 | 1 |
| York, ME | $29.87 | $29.87 – $29.87 | 14 | 1 |
| Devils Lake, ND | $503.97 | $503.97 – $503.97 | 14 | 1 |
| Newport, KY | $1.93 | $1.93 – $1.93 | 14 | 1 |
| Chagrin Falls, OH | $101.08 | $101.08 – $101.08 | 14 | 1 |
| Dorado, PR | $376.07 | $376.07 – $376.07 | 14 | 1 |
| Seguin, TX | $8.89 | $8.89 – $8.89 | 14 | 1 |
| Ainsworth, NE | $455.00 | $455.00 – $455.00 | 14 | 1 |
| Weaverville, CA | $253.65 | $253.65 – $253.65 | 14 | 1 |
| Ilwaco, WA | $1,331 | $1,331 – $1,331 | 14 | 1 |
| N Huntingdon, PA | $92.38 | $92.38 – $92.38 | 14 | 1 |
| Limerick, PA | $80.80 | $80.80 – $80.80 | 14 | 1 |
| Columbus, TX | $54.37 | $54.37 – $54.37 | 14 | 1 |
| Lucedale, MS | $51.38 | $51.38 – $51.38 | 14 | 1 |
| West Branch, MI | $398.99 | $398.99 – $398.99 | 14 | 1 |
| Fulton, MD | $93.06 | $93.06 – $93.06 | 14 | 1 |
| Ephrata, PA | $143.98 | $143.98 – $143.98 | 15 | 1 |
| Vienna, WV | $14.73 | $14.73 – $14.73 | 15 | 1 |
Cost Components
National averages for each billing code in this procedure category. Sorted by claim volume.
| 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 averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.