Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee

CPT Description 2010 MCR
Allowed
2011 MCR
Allowed
43217 ESPHGSC RGD/FLX W/RMVL TUM SNARE TQ $176.37 $183.45
43235 UPPER STOMACH-INTESTINE SCOPE FOR DIAGNOSIS $216.25 $154.82
43239 UPPER STOMACH-INTESTINE SCOPE FOR BIOPSY $251.15 $182.19
43244 UPR GI NDSC BAND LIG ESOPHGL&/GSTR VARC $233.67 $314.92
43246 UPR GI NDSC DIRED PLMT PRQ GASTROSTOMY TUBE $200.27 $269.67
43247 STOMACH-INTESTINE SCOPE FOR FOREIGN BODY REMOVAL $158.62 $214.03
43248 UPR GI NDSC INSJ GD WIRE DILAT ESOPH > GD WIRE $149.24 $200.34
43249 UPR GI NDSC BALO DILAT ESOPH < 30 MM DIAM $137.62 $184.87
43250 UPR GI NDSC RMVL LES HOT BX/BIPOLAR CAUT $149.64 $202.28
43251 UPR GI NDSC RMVL TUM POLYP/OTH LES SNARE TQ $172.38 $232.75
43255 UPR GI NDSC CTRL BLD ANY METH $223.14 $301.36
43256 UPR GI NDSC TNDSC STENT PLMT W/PREDILAT $263.98 $272.78
43260 ERCP DX COLLJ SPEC BR/WA SPX $274.63 $369.87
43262 ERCP W/SPHNCTROTOMY/PAPILLOTOMY $338.80 $457.21
43264 ERCP W/RMVL ST1/CALCULI BILIARY&/PNCRTC DUXS $531.64 $548.92
43265 ERCP W/DSTRJ LITHOTRP ST1/CALCULI ANY METH $597.62 $615.97
43271 ERCP W/BALO DILAT AMPULLA BILIARY&/PNCRTC DUX $339.02 $456.87
44360 SCOPE OF UPPER SMALL INTESTINE $161.61 $167.47
44361 SCOPE OF UPPER SMALL INTESTINE WITH BIOPSY $177.50 $183.96
44376 ENTEROSCOPY > 2ND PRTN W/ILE +-COLLJ SPEC SPX $314.93 $325.40
45330 DIAGNOSTIC SIGMOIDOSCOPY $97.75 $65.60
45331 SIGMOIDOSCOPY AND BIOPSY $122.63 $79.91
45334 SGMDSC FLX CTRL BLD $129.06 $173.78
45335 SGMDSC FLX DIRED SBMCSL NJX ANY SBST $93.70 $97.53
45338 SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ $277.71 $150.02
45378 SCOPE OF COLON FOR DIAGNOSIS $289.36 $231.77
45380 SCOPE OF COLON WITH BIOPSY $346.29 $276.94
45381 COLSC FLX PROX SPLENIC FLXR SBMCSL NJX $335.83 $262.58
45382 COLSC FLX PROX SPLENIC FLXR CTRL BLD $453.60 $353.06
45383 Colonoscopy with polyp ablation $346.54 $358.42
45384 COLSC FLX PROX SPLENIC FLXR RMVL LES CAUT $344.18 $289.44
45385 COLSC FLX PROX SPLENIC FLXR RMVL LES SNARE TQ $391.52 $328.64
45386 COLSC FLX PROX SPLENIC FLXR DILAT BALO 1+ STRIXS $474.25 $284.14
46221 HEMORRHOIDECTOMY SMPL LIGATURE $178.28 $189.18
46500 NJX SCLRSG SLN HEMORRHOIDS $120.93 $129.24
46930 Destruction of internal hemorrhoid(s) by therma  $142.76 $151.38
82270 TEST FOR BLOOD FECES $1.60 $4.58
91110 GI TRC IMG INTRAL ESOPH THRU ILE PHYS I&R $842.50 $904.77
99202 OFFICE VISIT NEW LEVEL 2 $67.46 $71.63
99203 OFFICE VISIT NEW LEVEL 3 $99.10 $104.77
99204 OFFICE VISIT NEW LEVEL 4 $154.59 $161.66
99205 OFFICE VISIT NEW LEVEL 5 $193.65 $200.96
99212 OFFICE VISIT EST. LEVEL 2 $39.13 $41.74
99213 OFFICE VISIT EST. LEVEL 3 $65.75 $69.68
99214 OFFICE VISIT EST. LEVEL 4 $98.37 $103.28
99219 Initial observation care per day for the evaluation and management of a patient $107.58 $109.67
99221 1ST HOSP CARE PR D 30 MIN $98.01 $100.44
99222 1ST HOSP CARE PR D 50 MIN $132.47 $136.05
99223 1ST HOSP CARE PR D 70 MIN $148.40 $198.99
99231 SBSQ HOSP CARE PR D 15 MIN $38.66 $39.21
99232 SBSQ HOSP CARE PR D 25 MIN $53.82 $70.57
99233 SBSQ HOSP CARE PR D 35 MIN $77.20 $101.48
99238 HOSP DSCHRG D MGMT 30 MIN/< $52.69 $69.93