Destruction of polyp or growth of esophagus, stomach, and/or upper small bowel using a flexible endoscope
Medicare pricing data for 4,932 providers across 49 states
This procedure has a 6.6x markup — hospitals charge $1,671 but Medicare allows only $252.51. Uninsured patients may face bills 6.6 times higher than what insurance negotiates. Prices vary significantly by location — from $196 in West Virginia to $503 in Wyoming. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Destruction of polyp or growth of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS code 43270) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $252.51, but hospitals typically charge $1,671 — a 6.6x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $252.51, your out-of-pocket cost would be approximately $50.50. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 6.6x more than what Medicare allows for this procedure. Medicare actually pays $196.39 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Wyoming | $503 | $3,759 | 6 | 15 | +99.2% |
| Vermont | $387 | $2,941 | 6 | 32 | +53.2% |
| Mississippi | $335 | $1,893 | 57 | 238 | +32.6% |
| California | $329 | $2,383 | 335 | 1,220 | +30.2% |
| Indiana | $309 | $3,174 | 129 | 658 | +22.5% |
| Nevada | $281 | $2,206 | 21 | 48 | +11.4% |
| Alabama | $277 | $1,481 | 86 | 329 | +9.7% |
| Michigan | $271 | $969 | 153 | 481 | +7.4% |
| New York | $270 | $2,331 | 264 | 876 | +7.1% |
| Tennessee | $269 | $1,488 | 110 | 432 | +6.7% |
| New Jersey | $266 | $2,826 | 143 | 519 | +5.5% |
| Oregon | $265 | $2,075 | 64 | 152 | +4.9% |
| Maryland | $264 | $1,469 | 76 | 363 | +4.6% |
| Idaho | $260 | $803 | 25 | 56 | +2.8% |
| Minnesota | $255 | $1,876 | 102 | 454 | +0.8% |
| Rhode Island | $252 | $1,312 | 17 | 59 | -0.1% |
| Texas | $252 | $1,499 | 379 | 1,262 | -0.3% |
| Florida | $251 | $1,249 | 360 | 1,578 | -0.6% |
| Louisiana | $249 | $1,328 | 84 | 316 | -1.2% |
| Kansas | $248 | $1,149 | 43 | 169 | -1.6% |
| North Carolina | $248 | $1,467 | 189 | 625 | -1.9% |
| Delaware | $247 | $683 | 10 | 26 | -2.1% |
| New Mexico | $246 | $1,182 | 19 | 83 | -2.5% |
| Missouri | $245 | $1,679 | 132 | 545 | -3.0% |
| District of Columbia | $240 | $829 | 13 | 101 | -5.0% |
| Montana | $238 | $1,571 | 17 | 47 | -5.8% |
| Arkansas | $236 | $2,104 | 36 | 116 | -6.7% |
| Ohio | $236 | $1,196 | 209 | 778 | -6.7% |
| Illinois | $232 | $1,716 | 231 | 948 | -8.1% |
| Georgia | $230 | $1,662 | 165 | 401 | -8.8% |
| Wisconsin | $229 | $3,063 | 119 | 401 | -9.4% |
| Massachusetts | $228 | $1,291 | 133 | 665 | -9.7% |
| Colorado | $228 | $1,233 | 56 | 181 | -9.9% |
| Pennsylvania | $225 | $1,003 | 292 | 951 | -10.8% |
| Washington | $221 | $1,091 | 107 | 328 | -12.4% |
| Connecticut | $221 | $1,594 | 54 | 183 | -12.4% |
| Oklahoma | $221 | $1,535 | 38 | 124 | -12.5% |
| New Hampshire | $221 | $3,869 | 32 | 148 | -12.5% |
| Arizona | $218 | $1,277 | 84 | 343 | -13.5% |
| South Carolina | $218 | $1,313 | 91 | 386 | -13.6% |
| Kentucky | $216 | $970 | 74 | 304 | -14.4% |
| Iowa | $214 | $1,173 | 31 | 83 | -15.3% |
| Virginia | $214 | $1,487 | 121 | 504 | -15.4% |
| Utah | $213 | $1,120 | 24 | 67 | -15.6% |
| North Dakota | $204 | $1,930 | 13 | 79 | -19.4% |
| Nebraska | $203 | $1,818 | 37 | 128 | -19.5% |
| South Dakota | $197 | $1,568 | 18 | 69 | -22.0% |
| Maine | $197 | $1,198 | 27 | 82 | -22.1% |
| West Virginia | $196 | $853 | 22 | 93 | -22.2% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber