GI – Hospital Fee Schedule for  FL



POS CPT    Description MCR
Allowed
Coins
20%
Comment
Hospital  43200 ESPHGSC RGD/FLX DX +-COLLJ SPEC BR/WA SPX $154.12 $30.82
Hospital  43202 ESPHGSC RGD/FLX W/BX 1/MLT $201.91 $40.38
Hospital  43235 UPPER STOMACH-INTESTINE SCOPE FOR DIAGNOSIS $216.25 $43.25
Hospital 43239 UPPER STOMACH-INTESTINE SCOPE FOR BIOPSY $251.15 $50.23
Hospital 43244 UPR GI NDSC BAND LIG ESOPHGL&/GSTR VARC $233.67 $46.73
Hospital 43245 UPR GI NDSC DILAT GSTR OUTLET FOR OBSTRCJ $148.87 $29.77
Hospital 43246 UPR GI NDSC DIRED PLMT PRQ GASTROSTOMY TUBE $200.27 $40.05
Hospital 43247 STOMACH-INTESTINE SCOPE FOR FOREIGN BODY REMOVAL $158.62 $31.72
Hospital 43248 UPR GI NDSC INSJ GD WIRE DILAT ESOPH > GD WIRE $149.24 $29.85
Hospital 43249 UPR GI NDSC BALO DILAT ESOPH < 30 MM DIAM $137.62 $27.52
Hospital 43250 UPR GI NDSC RMVL LES HOT BX/BIPOLAR CAUT $149.64 $29.93
Hospital 43251 UPR GI NDSC RMVL TUM POLYP/OTH LES SNARE TQ $172.38 $34.48
Hospital 43255 UPR GI NDSC CTRL BLD ANY METH $223.14 $44.63
Hospital 43260 ERCP DX COLLJ SPEC BR/WA SPX $274.63 $54.93
Hospital 43261 ERCP W/BX 1/MLT $288.88 $57.78
Hospital 43262 ERCP W/SPHNCTROTOMY/PAPILLOTOMY $338.80 $67.76
Hospital 43271 ERCP W/BALO DILAT AMPULLA BILIARY&/PNCRTC DUX $339.02 $67.80
Hospital 43760 SURGICAL CHANGE OF STOMACH TUBE $255.50 $51.10
Hospital 44360 SCOPE OF UPPER SMALL INTESTINE $123.90 $24.78
Hospital 44376 ENTEROSCOPY > 2ND PRTN W/ILE +-COLLJ SPEC SPX $241.07 $48.21
Hospital 44378 ENTEROSCOPY > 2ND PRTN ILE CTRL BLD $326.38 $65.28
Hospital 44388 SCOPE OF COLON THRU OSTOMY FOR DIAGNOSIS $251.02 $50.20
Hospital 44389 SCOPE OF COLON WITH BIOPSY THRU OSTOMY $287.53 $57.51
Hospital 45330 DIAGNOSTIC SIGMOIDOSCOPY $97.75 $19.55
Hospital 45331 SIGMOIDOSCOPY AND BIOPSY $122.63 $24.53
Hospital 45334 SGMDSC FLX CTRL BLD $129.06 $25.81
Hospital 45338 SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ $277.71 $55.54
Hospital 45339 SGMDSC FLX ABLTJ LES $241.69 $48.34
Hospital 45378 SCOPE OF COLON FOR DIAGNOSIS $289.36 $57.87
Hospital 45379 COLSC FLX PROX SPLENIC FLXR RMVL FB $367.68 $73.54
Hospital 45380 SCOPE OF COLON WITH BIOPSY $346.29 $69.26
Hospital 45381 COLSC FLX PROX SPLENIC FLXR SBMCSL NJX $335.83 $67.17
Hospital 45382 COLSC FLX PROX SPLENIC FLXR CTRL BLD $453.60 $90.72
Hospital 45384 COLSC FLX PROX SPLENIC FLXR RMVL LES CAUT $344.18 $68.84
Hospital 45385 COLSC FLX PROX SPLENIC FLXR RMVL LES SNARE TQ $391.52 $78.30
Hospital 45386 COLSC FLX PROX SPLENIC FLXR DILAT BALO 1+ STRIXS $474.25 $94.85
Hospital 46221 HEMORRHOIDECTOMY SMPL LIGATURE $178.28 $35.66
Hospital 46500 NJX SCLRSG SLN HEMORRHOIDS $149.28 $29.86
Hospital 46930 Destruction of internal hemorrhoid(s) by therma  $142.76 $28.55
Hospital 99223 1ST HOSP CARE PR D 70 MIN $148.40 $29.68
Hospital 99232 SBSQ HOSP CARE PR D 25 MIN $53.82 $10.76
Hospital 99233 SBSQ HOSP CARE PR D 35 MIN $77.20 $15.44
Hospital 99238 HOSP DSCHRG D MGMT 30 MIN/< $52.69 $10.54
Hospital 99252 Inpatient consultation low severity $0.00 Invalid CPT for the year 2010
Hospital 99253 1ST INPT CONSLTJ 55 MIN $0.00 Invalid CPT for the year 2010
Hospital 99254 1ST INPT CONSLTJ 80 MIN $0.00 Invalid CPT for the year 2010
Hospital 99283 EMER DEPT MODERATE SEVERITY $48.66 $9.73
Hospital G0121 Screening Colonoscopy (low risk) $281.04 $56.21