GI · CMS status A
43239
EGD w/ biopsy
EGD with biopsy, single or multiple.
Work RVU
2.39
2026 Medicare pays
$198.40
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 2.39 + Practice 3.32 + Malpractice 0.23 = 5.94 total
Work (your effort)Practice expenseMalpractice
When to use it
EGD with biopsy of one or more sites.
Documentation checklist
- ✓Biopsy sites and number.
- ✓Same documentation as 43235 plus biopsy details.
Common pitfalls
- !43249 if dilation also performed — bill both with appropriate modifiers.
Common modifiers
59
Common ICD-10 pairings
K21.9B96.81K22.7
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.