GI · CMS status A
43235
Diagnostic EGD
Esophagogastroduodenoscopy (EGD), flexible, transoral; diagnostic, with or without specimen collection by brushing or washing.
Work RVU
2.06
2026 Medicare pays
$177.02
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 2.06 + Practice 3.04 + Malpractice 0.20 = 5.30 total
Work (your effort)Practice expenseMalpractice
When to use it
Diagnostic EGD without biopsy or intervention.
Documentation checklist
- ✓Indication.
- ✓Scope insertion to second part of duodenum.
- ✓Findings and photo documentation.
- ✓Retroflexion in stomach.
Common pitfalls
- !If biopsy taken, use 43239.
Common ICD-10 pairings
K21.9K25.9
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.