{"procedure":{"code_type":"CPT","code":"43252","lay_name":"Upper endoscopy with microscopic imaging of the lining","blurb":"A flexible scope is passed through the mouth and a specialized probe magnifies the tissue lining to view it at the cellular level during the exam.","slug":"cpt-43252-upper-endoscopy-with-microscopic-imaging-of-the-lining","description":"PR Upr GI W/Optical Endomicroscopy","name_source":"llm:claude-opus-5","name_reviewed":false,"ccs":{"code":"70","label":"Upper gastrointestinal endoscopy, biopsy","surgery_flag":"neither"}},"settings":{"outpatient":{"setting":"outpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-23T18:34:04.741357Z","filing_date_min":"2024-07-01","filing_date_max":"2026-09-22","checked_from":"2026-09-05T10:45:50.833230Z","checked_through":"2026-09-25T01:09:37.598097Z","n_priced_setters":3956,"n_filed":356,"n_usable":313,"n_not_usable":3,"n_labelled":31,"n_no_cash":9,"n_estimated":0,"n_states":42,"cash_p10":342.63,"cash_p20":655.63,"cash_p25":846.3,"cash_p50":2267.12,"cash_p75":3867.58,"cash_p80":4316.0,"cash_p90":5384.79,"cash_mean_trimmed":2351.0,"gross_p50":4598.0,"cash_to_gross_p50":0.56,"medicare_rate":1960.47,"medicare_schedule":"opps","medicare_year":2026,"cash_to_medicare_p50":1.1564,"by_state":[{"state":"AK","n":2,"p20":null,"p50":null,"p80":null},{"state":"AL","n":2,"p20":null,"p50":null,"p80":null},{"state":"AR","n":2,"p20":null,"p50":null,"p80":null},{"state":"AZ","n":2,"p20":null,"p50":null,"p80":null},{"state":"CA","n":50,"p20":2528.9,"p50":3354.4,"p80":4316.0},{"state":"CO","n":2,"p20":null,"p50":null,"p80":null},{"state":"FL","n":18,"p20":3088.25,"p50":4596.9,"p80":4897.6},{"state":"GA","n":2,"p20":null,"p50":null,"p80":null},{"state":"HI","n":1,"p20":null,"p50":null,"p80":null},{"state":"IA","n":15,"p20":607.0,"p50":797.6,"p80":797.6},{"state":"ID","n":7,"p20":null,"p50":null,"p80":null},{"state":"IL","n":21,"p20":443.8,"p50":2372.3,"p80":2755.2},{"state":"IN","n":6,"p20":null,"p50":null,"p80":null},{"state":"KS","n":1,"p20":null,"p50":null,"p80":null},{"state":"KY","n":4,"p20":null,"p50":null,"p80":null},{"state":"LA","n":12,"p20":992.42,"p50":1097.6,"p80":1493.37},{"state":"MA","n":11,"p20":5890.0,"p50":8652.0,"p80":9965.61},{"state":"MD","n":1,"p20":null,"p50":null,"p80":null},{"state":"MI","n":5,"p20":null,"p50":null,"p80":null},{"state":"MN","n":5,"p20":null,"p50":null,"p80":null},{"state":"MO","n":3,"p20":null,"p50":null,"p80":null},{"state":"MS","n":1,"p20":null,"p50":null,"p80":null},{"state":"NC","n":1,"p20":null,"p50":null,"p80":null},{"state":"ND","n":2,"p20":null,"p50":null,"p80":null},{"state":"NE","n":5,"p20":null,"p50":null,"p80":null},{"state":"NH","n":5,"p20":null,"p50":null,"p80":null},{"state":"NJ","n":24,"p20":2099.7,"p50":3786.0,"p80":5741.0},{"state":"NM","n":2,"p20":null,"p50":null,"p80":null},{"state":"NV","n":2,"p20":null,"p50":null,"p80":null},{"state":"NY","n":20,"p20":440.76,"p50":2244.82,"p80":2244.82},{"state":"OH","n":8,"p20":null,"p50":null,"p80":null},{"state":"OK","n":12,"p20":275.8,"p50":275.8,"p80":275.8},{"state":"OR","n":2,"p20":null,"p50":null,"p80":null},{"state":"PA","n":17,"p20":1285.52,"p50":2267.12,"p80":3574.47},{"state":"SC","n":3,"p20":null,"p50":null,"p80":null},{"state":"TN","n":7,"p20":null,"p50":null,"p80":null},{"state":"TX","n":12,"p20":1494.48,"p50":1494.48,"p80":1494.48},{"state":"VA","n":4,"p20":null,"p50":null,"p80":null},{"state":"VT","n":1,"p20":null,"p50":null,"p80":null},{"state":"WA","n":5,"p20":null,"p50":null,"p80":null},{"state":"WI","n":7,"p20":null,"p50":null,"p80":null},{"state":"WY","n":1,"p20":null,"p50":null,"p80":null}],"by_segment":{"hospital_type":[{"key":"acute","n":266,"p20":797.6,"p50":2277.71,"p80":4316.0},{"key":"childrens","n":6,"p20":null,"p50":null,"p80":null},{"key":"critical_access","n":40,"p20":443.8,"p50":821.52,"p80":5384.79}],"ownership":[{"key":"for_profit","n":27,"p20":443.8,"p50":1474.8,"p80":3653.25},{"key":"government","n":44,"p20":880.0,"p50":2244.82,"p80":4596.9},{"key":"nonprofit","n":241,"p20":797.6,"p50":2372.3,"p80":4316.0}],"affiliation":[{"key":"affiliated","n":277,"p20":797.6,"p50":2267.12,"p80":4350.0},{"key":"independent","n":36,"p20":448.0,"p50":1437.7,"p80":3318.9}]},"histogram":[{"lo":270.86,"hi":378.0,"n":20},{"lo":378.0,"hi":527.52,"n":25},{"lo":527.52,"hi":736.18,"n":5},{"lo":736.18,"hi":1027.38,"n":30},{"lo":1027.38,"hi":1433.76,"n":16},{"lo":1433.76,"hi":2000.89,"n":23},{"lo":2000.89,"hi":2792.34,"n":53},{"lo":2792.34,"hi":3896.86,"n":51},{"lo":3896.86,"hi":5438.28,"n":51},{"lo":5438.28,"hi":7589.4,"n":11}],"previous":null},"inpatient":{"setting":"inpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-23T22:20:53.406353Z","filing_date_min":"2024-07-01","filing_date_max":"2026-09-16","checked_from":"2026-09-05T11:18:47.736875Z","checked_through":"2026-09-25T01:09:37.598097Z","n_priced_setters":3956,"n_filed":265,"n_usable":229,"n_not_usable":2,"n_labelled":11,"n_no_cash":23,"n_estimated":0,"n_states":37,"cash_p10":275.8,"cash_p20":475.0,"cash_p25":797.6,"cash_p50":2267.12,"cash_p75":4316.0,"cash_p80":4686.0,"cash_p90":8652.0,"cash_mean_trimmed":2434.42,"gross_p50":4871.0,"cash_to_gross_p50":0.56,"medicare_rate":null,"medicare_schedule":null,"medicare_year":null,"cash_to_medicare_p50":null,"by_state":[{"state":"AL","n":3,"p20":null,"p50":null,"p80":null},{"state":"AZ","n":1,"p20":null,"p50":null,"p80":null},{"state":"CA","n":45,"p20":3354.4,"p50":3354.4,"p80":4316.0},{"state":"CO","n":1,"p20":null,"p50":null,"p80":null},{"state":"FL","n":14,"p20":3088.25,"p50":4596.9,"p80":4897.6},{"state":"GA","n":2,"p20":null,"p50":null,"p80":null},{"state":"IA","n":16,"p20":712.2,"p50":797.6,"p80":797.6},{"state":"ID","n":7,"p20":null,"p50":null,"p80":null},{"state":"IL","n":15,"p20":443.8,"p50":797.6,"p80":3424.0},{"state":"IN","n":10,"p20":208.8,"p50":443.8,"p80":443.8},{"state":"KS","n":2,"p20":null,"p50":null,"p80":null},{"state":"KY","n":4,"p20":null,"p50":null,"p80":null},{"state":"LA","n":7,"p20":null,"p50":null,"p80":null},{"state":"MA","n":11,"p20":5890.0,"p50":8652.0,"p80":9965.61},{"state":"MI","n":1,"p20":null,"p50":null,"p80":null},{"state":"MN","n":4,"p20":null,"p50":null,"p80":null},{"state":"MO","n":4,"p20":null,"p50":null,"p80":null},{"state":"MS","n":3,"p20":null,"p50":null,"p80":null},{"state":"NC","n":1,"p20":null,"p50":null,"p80":null},{"state":"ND","n":1,"p20":null,"p50":null,"p80":null},{"state":"NE","n":3,"p20":null,"p50":null,"p80":null},{"state":"NH","n":5,"p20":null,"p50":null,"p80":null},{"state":"NJ","n":3,"p20":null,"p50":null,"p80":null},{"state":"NM","n":1,"p20":null,"p50":null,"p80":null},{"state":"NV","n":2,"p20":null,"p50":null,"p80":null},{"state":"NY","n":5,"p20":null,"p50":null,"p80":null},{"state":"OH","n":7,"p20":null,"p50":null,"p80":null},{"state":"OK","n":10,"p20":275.8,"p50":275.8,"p80":275.8},{"state":"OR","n":1,"p20":null,"p50":null,"p80":null},{"state":"PA","n":12,"p20":2212.6,"p50":2267.12,"p80":3574.47},{"state":"TN","n":5,"p20":null,"p50":null,"p80":null},{"state":"TX","n":11,"p20":1494.48,"p50":1494.48,"p80":1494.48},{"state":"VA","n":4,"p20":null,"p50":null,"p80":null},{"state":"VT","n":2,"p20":null,"p50":null,"p80":null},{"state":"WA","n":4,"p20":null,"p50":null,"p80":null},{"state":"WV","n":1,"p20":null,"p50":null,"p80":null},{"state":"WY","n":1,"p20":null,"p50":null,"p80":null}],"by_segment":{"hospital_type":[{"key":"acute","n":191,"p20":578.0,"p50":2528.9,"p80":4316.0},{"key":"childrens","n":2,"p20":null,"p50":null,"p80":null},{"key":"critical_access","n":35,"p20":443.8,"p50":1494.48,"p80":9965.61}],"ownership":[{"key":"for_profit","n":22,"p20":270.86,"p50":443.8,"p80":3653.25},{"key":"government","n":37,"p20":880.0,"p50":3060.6,"p80":8652.0},{"key":"nonprofit","n":169,"p20":504.36,"p50":2528.9,"p80":4316.0}],"affiliation":[{"key":"affiliated","n":197,"p20":504.36,"p50":2267.12,"p80":4596.9},{"key":"independent","n":32,"p20":452.67,"p50":1904.16,"p80":9700.56}]},"histogram":[{"lo":270.86,"hi":397.69,"n":17},{"lo":397.69,"hi":583.92,"n":23},{"lo":583.92,"hi":857.35,"n":20},{"lo":857.35,"hi":1258.82,"n":16},{"lo":1258.82,"hi":1848.29,"n":19},{"lo":1848.29,"hi":2713.78,"n":15},{"lo":2713.78,"hi":3984.55,"n":42},{"lo":3984.55,"hi":5850.38,"n":35},{"lo":5850.38,"hi":8589.92,"n":6},{"lo":8589.92,"hi":12612.3,"n":15}],"previous":null}},"related":[{"code_type":"CPT","code":"43235","lay_name":"Diagnostic upper endoscopy","slug":"cpt-43235-diagnostic-upper-endoscopy"},{"code_type":"CPT","code":"43239","lay_name":"Upper endoscopy with biopsy","slug":"cpt-43239-upper-endoscopy-with-biopsy"},{"code_type":"CPT","code":"43247","lay_name":"Upper endoscopy with removal of a swallowed object","slug":"cpt-43247-upper-endoscopy-with-removal-of-a-swallowed-object"},{"code_type":"CPT","code":"43251","lay_name":"Upper endoscopy with growth removal by wire snare","slug":"cpt-43251-upper-endoscopy-with-growth-removal-by-wire-snare"},{"code_type":"CPT","code":"43255","lay_name":"Upper endoscopy with control of bleeding","slug":"cpt-43255-upper-endoscopy-with-control-of-bleeding"},{"code_type":"CPT","code":"43236","lay_name":"Upper endoscopy with injection into the stomach lining","slug":"cpt-43236-upper-endoscopy-with-injection-into-the-stomach-lining"},{"code_type":"CPT","code":"43200","lay_name":"Esophagus exam with a flexible scope through the mouth","slug":"cpt-43200-esophagus-exam-with-a-flexible-scope-through-the-mouth"},{"code_type":"CPT","code":"43250","lay_name":"Upper endoscopy with growth removal using heated forceps","slug":"cpt-43250-upper-endoscopy-with-growth-removal-using-heated-forceps"},{"code_type":"CPT","code":"43270","lay_name":"Upper endoscopy with destruction of a growth","slug":"cpt-43270-upper-endoscopy-with-destruction-of-a-growth"},{"code_type":"CPT","code":"43202","lay_name":"Esophagus scope exam with tissue sample","slug":"cpt-43202-esophagus-scope-exam-with-tissue-sample"},{"code_type":"CPT","code":"43241","lay_name":"Upper endoscopy with placement of a feeding tube or catheter","slug":"cpt-43241-upper-endoscopy-with-placement-of-a-feeding-tube-or-catheter"},{"code_type":"CPT","code":"44361","lay_name":"Small bowel endoscopy with biopsy","slug":"cpt-44361-small-bowel-endoscopy-with-biopsy"}]}