Price Checker / CPT 43239

How much does Upper endoscopy with biopsy cost?

CPT 43239 · Based on 2026 Medicare rates and hospital-published pricing

Overpriced

The average hospital charge is about 3.1x the fair price. You have grounds to ask for a reduction.

Fair price

$1,700–$2,000

What this should cost

With insurance

~$2,400

Typical out-of-pocket

Overcharged if over

$2,500

Push back above this

The average hospital charge of $5,687 is $3,837 over the fair price (about 3.1x the fair rate).

What hospitals charge for Upper endoscopy with biopsy

From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.

HospitalGross ChargeCash Ratevs Medicare
Stony Brook Eastern Long Island Hospital

, NY

$2,14018054%
Beartooth Billings Clinic

RED LODGE, MT

$23,7295565%
Down East Community Hospital

Machias, ME

$21,3174557%
Hill Regional Hospital

Hillsboro, TX

$14,3752817%
Los Alamos Medical Center

LOS ALAMOS, NY

$11,2842594%
West Holt Memorial Hospital

Atkinson, NE

$10,0992215%
Kindred Hospital La Mirada

La Mirada, CA

$9,3722138%
Kindred Hospital San Gabriel Valley

West Covina, CA

$9,3722138%
Kindred Hospital Santa Ana

Santa Ana, CA

$9,3722138%
Bourbon Community Hospital

PARIS, KY

$8,6451964%
Community Medical Center

Falls City, NE

$8,6261898%
Kearney County Hospital

, NE

$6,824$5,4591529%
Kindred Hospital Las Vegas - Flamingo

Las Vegas, NV

$5,9231314%
Kindred Hospital Las Vegas - Sahara

Las Vegas, NV

$5,9231314%
Solara Specialty Hospital Mcallen

Mc Allen, TX

$5,7941283%

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About Upper endoscopy with biopsy

CPT code 43239 refers to upper endoscopy with biopsy (billing description: "Egd biopsy single/multiple"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $124 in a facility (hospital or surgery center) and $419 in a doctor's office.

The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.

What to do if you were overcharged

  1. 1Send us your billwe'll identify this code and compare it against the rates shown above.
  2. 2Get a dispute letterciting the Medicare rate and your hospital's own published pricing data.
  3. 3We negotiate for you25% of savings, no savings = no fee.

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