How Much Does Egd Diagnostic Brush Wash Cost?
Also known as: Egd diagnostic brush wash (CPT 43235)
Esophagogastroduodenoscopy (EGD) - diagnostic upper endoscopy without biopsy.
The total estimated cost of Egd Diagnostic Brush Wash (CPT 43235) is $371 to $696, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $111.
Total Estimated Cost of Care
This estimate includes hospital facility fees, anesthesia, and supplies .
Patient Guide: Egd Diagnostic Brush Wash
What you need to know before your appointment
What to Expect
After sedation, a thin flexible camera is guided through your mouth to examine the esophagus, stomach, and upper small intestine. The doctor looks for ulcers, inflammation, and other problems.
How Long Does It Take?
15-20 minutes (plus recovery)
Common Reasons Doctors Order This
Heartburn evaluation, difficulty swallowing, stomach pain, nausea evaluation, anemia workup
How to Prepare
Fast for 6-8 hours. Arrange a driver. Continue essential medications with a tiny sip of water unless told otherwise.
Procedures Commonly Done Together
These procedures are frequently performed alongside Egd diagnostic brush wash
How to Reduce Your Cost for Egd diagnostic brush wash
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
For this procedure, the office rate ($323) differs from the facility rate ($111). Ask if it can be done in an office setting.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (9.66) x CF ($33.40) = $323
Related Procedures
Similar procedures in the same category or body system
People Also Ask
Common questions people search for about this procedure
How much do endoscopies cost without insurance?
Is an upper endoscopy worth it?
An upper GI endoscopy can be used to identify disorders or problems such as: GERD (gastroesophageal reflux disease) Narrowing (strictures) or blockages. Larger than normal veins in your esophagus (esophageal varices)
Does insurance cover an upper endoscopy?
If medically necessary: If your doctor recommends an endoscopy to diagnose symptoms like acid reflux, ulcers, or gastrointestinal bleeding, insurance may cover part of the cost —but you'll likely have deductibles, copays, or coinsurance.
Why is an upper endoscopy so expensive?
Healthcare Setting: Undergoing an endoscopy in a public hospital may be less expensive than in a private clinic. However, private facilities often provide faster access to the procedure and personalized care. Use of Sedation: Some patients require moderate to deep sedation for comfort, which adds to the overall cost.
Frequently Asked Questions
How much does Egd diagnostic brush wash cost?
The Medicare facility rate for Egd diagnostic brush wash is $111. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Egd diagnostic brush wash cost without insurance?
Without insurance, the cost of Egd diagnostic brush wash can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Egd diagnostic brush wash?
Most commercial health insurance plans and Medicare cover Egd diagnostic brush wash when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.