CPT 43235

Esophagogastroduodenoscopy Transoral Diagnostic

CPT 43235 pays $322.65 in a non-facility setting and $110.56 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $284.01 in Arkansas to $371.11 in District of Columbia, a 31% spread.

National non-facility rate

$322.65

Office and other outpatient settings

Facility rate
$110.56

Hospital and ASC settings

Highest state
$371.11

District of Columbia

Lowest state
$284.01

Arkansas · 31% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $322.65
CPT 43235 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $322.65, national facility $110.56.
StateRate compared visuallyNon-facilityFacility
District of Columbia
$371.11$121.27
Alaska
$369.14$143.26
California
$366.60$115.63
New Jersey
$357.88$119.06
Washington
$357.62$115.83
New York
$357.26$120.65
Massachusetts
$353.78$115.49
Hawaii
$353.05$111.90
Connecticut
$344.68$116.25
Colorado
$337.49$111.82
Maryland
$334.64$113.53
Oregon
$334.17$110.73
New Hampshire
$331.76$110.97
Rhode Island
$331.22$112.12
Florida
$331.06$118.26
Puerto Rico
$325.24$110.82
Virgin Islands
$325.24$110.82
Minnesota
$324.16$105.91
Montana
$322.64$110.54
Illinois
$321.87$116.94
Nevada
$321.56$109.25
Wyoming
$320.57$108.47
Delaware
$319.23$109.68
Pennsylvania
$318.77$111.02
Texas
$318.64$109.83
North Dakota
$317.89$105.80
South Dakota
$317.33$105.23
Vermont
$316.23$106.25
Virginia
$316.11$107.62
Arizona
$313.86$108.34
Georgia
$312.99$110.65
Michigan
$310.88$111.73
Maine
$308.69$106.03
Utah
$307.05$107.68
Wisconsin
$306.75$103.56
New Mexico
$303.80$109.31
North Carolina
$303.24$105.36
South Carolina
$302.72$106.74
Missouri
$302.23$107.60
Louisiana
$301.58$107.94
Ohio
$301.27$107.63
Indiana
$300.54$103.93
Idaho
$298.71$103.58
Nebraska
$298.69$102.92
Iowa
$296.87$102.80
Tennessee
$296.51$103.71
Kansas
$295.01$103.28
Kentucky
$294.61$106.06
Oklahoma
$294.49$105.09
West Virginia
$293.82$109.51
Alabama
$288.36$102.78
Mississippi
$286.30$103.68
Arkansas
$284.01$101.82

Billed by 1 specialties

Commercial rates for 43235

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates