CMS Payment Rates for 6 Upper GI Procedures

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1. Upper GI endoscopy including esophagus, stomach and either duodenum and/or jejunum as appropriate; with removal of tumors, polyps, or other lesions by hot biopsy forceps or bipolar cautery (CPT 43250) — $369.45

2. Upper GI endoscopy including esophagus, stomach and either duodenum and/or jejunum as appropriate; with removal of tumors, polyps or other lesions by snare technique (CPT 43251) — $369.45

3. Upper GI endoscopy including esophagus, stomach and either duodenum and/or jejunum as appropriate; diagnostic, with control of bleeding any method (CPT 43255) — $369.45

4. Upper GI endoscopy including esophagus, stomach and either duodenum and/or jejunum as appropriate; diagnostic, with transendoscopic stent placement (includes predilation) (CPT 43256) — $917.91

5. Upper GI endoscopy including esophagus, stomach and either duodenum and/or jejunum as appropriate; with ablation of tumors, polyps, or other lesions not amenable by hot biopsy forceps, bipolar cautery or snare technique (CPT 43258) — $384.76

6. Upper GI endoscopy including endoscopic ultrasound (CPT 43259) — $384.76

Source: Federal Register, Vol. 74, No. 223 (pdf).