Medicare Reimbursement: 28 Statistics on Upper GI Endoscopy Facility Fees in 2012 vs. 2013

How has Medicare facility fee reimbursement for upper gastrointestinal endoscopy services changed from 2012 to 2013?

Here are 28 statistics on upper GI endoscopy facility fees for ambulatory surgery centers and hospital outpatient departments over the past two years, according to the American College of Gastroenterology.

Upper GI endoscopy, diagnosis (HCPCS 43235)

2012
•    ASC: $341.01
•    HOPD: $549.71

2013:
•    ASC: $342.83
•    HOPD: $610.98

Upper GI endoscopy, biopsy (HCPCS 43239)

2012
•    ASC: $341.01
•    HOPD: $591.71

2013:
•    ASC: $342.83
•    HOPD: $610.98

Upper GI endoscopy w/us fn bx (HCPCS 43242)

2012
•    ASC: $511.13
•    HOPD: $886.90

2013:
•    ASC: $509.65
•    HOPD: $908. 24

Upper GI endoscopy/ligation (HCPCS 43244)

2012
•    ASC: $511.13
•    HOPD: $886.90

2013:
•    ASC: $509.65
•    HOPD: $908.24

Operative upper GI endoscopy (HCPCS 43247)

2012
•    ASC: $341.01
•    HOPD: $591.71

2013:
•    ASC: $342.83
•    HOPD: $610.98

Upper GI endoscopy/guide wire (HCPCS 43248)

2012
•    ASC: $341.01
•    HOPD: $591.71

2013:
•    ASC: $342.83
•    HOPD: $610.98

Operative upper GI endoscopy (HCPCS 43255)

2012
•    ASC: $511.13
•    HOPD: $886.90

2013:
•    ASC: $509.65
•    HOPD: $908. 24

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