CPT 43259

Upper GI Endoscopy

Current code40 hospitals with prices

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for CPT 43259 by hospital
Hospital	Medicaid managed care rates (lowest – highest)	Cash price	List price (before discounts)
EvergreenHealth Medical CenterKirkland	—	$3,192	$3,990
Harborview Medical CenterSeattleFile dated 2026-04-01	—	$6,359	$9,085
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01	—	$407	$626
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01	—	$2,070	$4,140
Seattle Children's HospitalSeattle	$132 – $2,41913 plans	$930 – $7,441	$930 – $7,441
Skagit Valley HospitalMount Vernon	$177 – $2113 plans	$4,434	$5,543
Trios HealthKennewick	—	—	$39,490
University of Washington Medical CtrSeattleFile dated 2026-04-01	—	$4,731	$6,759
Virginia Mason Medical CenterSeattle	—	$2,657	$5,209

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County): $215 in a hospital or surgery center
Doctor's fee, rest of Washington: $200 in a hospital or surgery center
Hospital outpatient payment (national): $1,960 (APC 5302)
Surgery center payment (national): $894