How Much Does Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope Cost on Medicare?

The data suggests significant pricing inconsistencies for CPT 43239. With a 2.7x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.

Costs have remained relatively stable over time, but the geographic variation suggests Medicare's geographic adjustment factors may not fully capture the true cost differences across states.

This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.