CPT43235

Upper Endoscopy (EGD) Cost in Alaska

Egd diagnostic brush wash

$1,037Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Alaska Medicare physician rate (2026)

+14.4% vs national

Single statewide locality.

Alaska (Hospital)
$143.26
Facility physician fee
Private plan est.
$480–$738
~130–200% of Medicare
Cash / self-pay est.
$295–$554
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Surgery centre, total
$608
$111 physician + $498 facility
Physician fee alone
$111
Only 11% of the hospital total

Choosing a surgery centre over a hospital saves about $429 on the Medicare allowed amount for upper endoscopy (egd). Ask whether your procedure can be done at an ambulatory surgery centre.

This is Medicare's separate payment to the facility on top of the physician's fee. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.

Your ZIP in Alaska

Look up your ZIP code to see Alaska's adjusted rates, whether you are in Anchorage, Fairbanks, Juneau, the Mat-Su Valley, or a fly-in community off the road system.

What upper endoscopy (egd) costs at hospitals near you

Everything above is a national average. The hospital you pick in Alaska moves the bill more than anything else you control.

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Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Alaska the office and hospital physician lines for this CPT differ by $225.88.

National vs Alaska

National office$322.65
National hospital (physician)$110.56
Alaska vs national14% above the national office rate of $322.65

Where Alaska ranks for this CPT

Rank (lowest physician fee first)#50 of 51
Lowest stateArkansas ($284.01)
Highest stateDistrict of Columbia ($371.11)

Upper Endoscopy (EGD) and how Alaska is priced

Alaska stands apart in the Medicare fee schedule: it is a single statewide locality, but federal law sets a permanent 1.5 floor on its physician work adjustment, the highest geographic treatment in the country. Combined with elevated practice expense indices that reflect the real cost of running a clinic in a remote state, Alaska's Medicare-approved amounts are consistently the highest of any state. Every community from Anchorage to the smallest bush village prices off the same locality, so the premium applies statewide rather than only in the cities.

Anchorage holds most of the state's specialists, and Fairbanks and Juneau add regional capacity, but many Alaskans still fly to Anchorage or even Seattle for complex procedures. Travel and lodging can rival the medical bill itself for residents of remote communities, which makes planning ahead unusually important here. Tribal health facilities also play a large role in care delivery across much of the state.

This procedure: An upper endoscopy, or EGD, passes a thin flexible camera through the mouth to examine the esophagus, stomach, and the first part of the small intestine. It investigates problems like persistent heartburn, swallowing difficulty, unexplained anemia, or upper abdominal pain. You receive sedation through an IV, the exam itself takes 10 to 20 minutes, and you go home the same day once the sedation wears off, needing a driver.

What Is Upper Endoscopy (EGD)?

An upper endoscopy, or EGD, passes a thin flexible camera through the mouth to examine the esophagus, stomach, and the first part of the small intestine. It investigates problems like persistent heartburn, swallowing difficulty, unexplained anemia, or upper abdominal pain. You receive sedation through an IV, the exam itself takes 10 to 20 minutes, and you go home the same day once the sedation wears off, needing a driver.

What Affects the Cost

  • The choice between a hospital outpatient department and a freestanding endoscopy center is the single biggest price lever.
  • Sedation billed by a separate anesthesia provider, especially propofol given by an anesthesiologist or CRNA, adds a significant independent charge.
  • This code is the diagnostic-only exam; if the doctor takes even one biopsy the procedure is recoded to 43239 at a higher rate plus lab fees.
  • Pre-procedure consultation visits with the gastroenterologist are billed separately from the endoscopy itself.
  • Facility fees vary more than physician fees, so the same doctor can cost very different amounts at different locations.

Questions to Ask Before Booking

  • 1.Can this be scheduled at a freestanding endoscopy center rather than the hospital, and what is the facility fee at each?
  • 2.Who provides the sedation, what type is used, and are they in my network?
  • 3.If you take biopsies during the exam, how much does the procedure code and pathology add?
  • 4.Is prior authorization required and has it been obtained?
  • 5.What is the all-in estimate including physician, facility, anesthesia, and pathology?

Upper Endoscopy (EGD) in Alaska: questions

Alaska is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 43235 is $369.14 in an office and $143.26 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Alaska uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $74 for the office physician line or $29 for the hospital physician line in Alaska. Medigap may cover that 20%. This is not the hospital facility fee.

No. $369.14 is only the physician's share. Adding Medicare's facility payment brings the total to about $1,037 in a hospital outpatient department, or about $608 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. Alaska ranks #50 of 51 states on the physician line (14% above the national office rate of $322.65).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.