Upper Endoscopy (EGD) With Biopsy Cost in California

Egd biopsy single/multiple

CPT 43239

California Average Cost (2026)

+14.2% vs national avg

Average across 29 Medicare localities in California

California (Office)
$478.36
Non-facility rate
California (Hospital)
$128.98
Facility rate
Private Insurance Est.
$622 - $957
130-200% of Medicare
Self-Pay / Cash Est.
$383 - $718
80-150% of Medicare

National Average

Office Rate$418.85
Hospital Rate$123.58

State Ranking

California rank#48 of 49 (most expensive)
Cheapest stateArkansas ($367.66)
Most expensiveDistrict of Columbia ($483.17)

Cost by Region in California

RegionOffice Rate
san jose-sunnyvale-santa clara (san benito cnty)$569.97
san jose-sunnyvale-santa clara (santa clara cnty)$568.72
san francisco-oakland-berkeley (marin cnty)$557.48
san francisco-oakland-berkeley (san francisco/san mateo/alameda/contra costa cnty)$557.18
napa$524.89
vallejo$524.45
santa rosa-petaluma$492.69
santa cruz-watsonville$487.68
san diego-chula vista-carlsbad$482.12
los angeles-long beach-anaheim (los angeles/orange cnty)$479.76
oxnard-thousand oaks-ventura$478.05
santa maria-santa barbara$471.95
sacramento-roseville-folsom$471.58
salinas$469.86
san luis obispo-paso robles$462.13
riverside-san bernardino-ontario$450.79
bakersfield$448.67
el centro$447.90
chico$447.86
fresno$447.86
hanford-corcoran$447.86
madera$447.86
merced$447.86
modesto$447.86
redding$447.86
stockton$447.86
visalia$447.86
yuba city$447.86
rest of california$447.86

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About Upper Endoscopy (EGD) With Biopsy Costs in California

The average Medicare reimbursement for upper endoscopy (egd) with biopsy in California is $478.36 for an office setting and $128.98 in a hospital. This is about 14% higher than the national average of $418.85.

Medicare patients typically pay 20% of the Medicare rate after meeting their deductible. For this procedure in California, that would be roughly $96 for an office visit or $26 in a hospital setting.

Private insurance plans in California typically pay between 130% and 200% of Medicare rates for this procedure, putting the total somewhere between $622 and $957.

Without insurance, you may be able to negotiate a cash discount. Many providers in California will reduce their fees by 20% to 40% for self-pay patients. Always ask about cash pricing before scheduling your procedure.

Ways to Save on Upper Endoscopy (EGD) With Biopsy

Compare Insurance Plans

Uninsured? Comparing marketplace plans in California could save you thousands on procedures like this.

Compare plans on eHealth

Try Telehealth First

Many consultations can be done virtually for $50-100, saving hundreds vs an in-person visit.

Book on Sesame Care

Save on Prescriptions

If this procedure leads to a prescription, check discount cards for up to 80% savings.

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Upper Endoscopy (EGD) With Biopsy in California: Frequently Asked Questions

How much does upper endoscopy (egd) with biopsy cost in California?

The average 2026 Medicare rate for upper endoscopy (egd) with biopsy (CPT 43239) in California is $478.36 in an office setting and $128.98 in a hospital. Private insurance typically pays $622 to $957, and self-pay cash prices often run $383 to $718.

Is upper endoscopy (egd) with biopsy cheaper in California than the national average?

California is about 14% higher than the national average of $418.85. Across all states, California ranks #48 of 49 for this procedure. The cheapest state is Arkansas ($367.66) and the most expensive is District of Columbia ($483.17).

What will I pay out of pocket for upper endoscopy (egd) with biopsy in California with Medicare?

Medicare patients typically pay 20% of the Medicare rate after meeting their deductible. In California that is roughly $96 for an office visit or $26 in a hospital setting.

How can I save on upper endoscopy (egd) with biopsy in California?

Ask providers for a cash or self-pay price before scheduling; many in California reduce fees 20% to 40% for self-pay patients. If you are uninsured, comparing marketplace plans, using telehealth for consultations, and checking prescription discount cards can cut costs further.

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts and may not reflect actual charges. Private insurance and self-pay estimates are approximations based on industry averages.