{"procedure":{"code_type":"CPT","code":"43254","lay_name":"Upper endoscopy with removal of a lesion from the lining","blurb":"A flexible scope is passed through the mouth and an area of abnormal lining is lifted and cut away from the esophagus, stomach or upper small intestine.","slug":"cpt-43254-upper-endoscopy-with-removal-of-a-lesion-from-the-lining","description":"Egd Transoral Endoscopic Mucosal Resection","name_source":"llm:claude-opus-5","name_reviewed":false,"ccs":{"code":"70","label":"Upper gastrointestinal endoscopy, biopsy","surgery_flag":"broad"}},"settings":{"outpatient":{"setting":"outpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-23T22:20:23.317834Z","filing_date_min":"2024-06-18","filing_date_max":"2026-09-22","checked_from":"2026-09-05T02:22:45.003818Z","checked_through":"2026-09-25T01:13:52.941847Z","n_priced_setters":3956,"n_filed":968,"n_usable":907,"n_not_usable":1,"n_labelled":38,"n_no_cash":16,"n_estimated":6,"n_states":50,"cash_p10":508.66,"cash_p20":687.2,"cash_p25":979.82,"cash_p50":2117.5,"cash_p75":3549.65,"cash_p80":4083.75,"cash_p90":5671.9,"cash_mean_trimmed":2171.02,"gross_p50":4056.0,"cash_to_gross_p50":0.6,"medicare_rate":1960.47,"medicare_schedule":"opps","medicare_year":2026,"cash_to_medicare_p50":1.0801,"by_state":[{"state":"AK","n":2,"p20":null,"p50":null,"p80":null},{"state":"AL","n":9,"p20":null,"p50":null,"p80":null},{"state":"AR","n":4,"p20":null,"p50":null,"p80":null},{"state":"AZ","n":8,"p20":null,"p50":null,"p80":null},{"state":"CA","n":73,"p20":792.72,"p50":2430.4,"p80":5222.0},{"state":"CO","n":17,"p20":1257.15,"p50":1815.0,"p80":2117.5},{"state":"CT","n":8,"p20":null,"p50":null,"p80":null},{"state":"DE","n":1,"p20":null,"p50":null,"p80":null},{"state":"FL","n":33,"p20":1918.0,"p50":2740.0,"p80":4009.4},{"state":"GA","n":26,"p20":1271.7,"p50":1271.7,"p80":4378.0},{"state":"HI","n":7,"p20":null,"p50":null,"p80":null},{"state":"IA","n":19,"p20":522.0,"p50":684.0,"p80":1428.3},{"state":"ID","n":12,"p20":1803.0,"p50":3688.2,"p80":4686.0},{"state":"IL","n":28,"p20":457.1,"p50":1557.9,"p80":3124.8},{"state":"IN","n":29,"p20":1082.0,"p50":2020.0,"p80":3959.41},{"state":"KS","n":4,"p20":null,"p50":null,"p80":null},{"state":"KY","n":18,"p20":392.0,"p50":1847.32,"p80":7617.19},{"state":"LA","n":17,"p20":730.38,"p50":975.92,"p80":1195.88},{"state":"MA","n":27,"p20":1689.75,"p50":2588.0,"p80":5629.0},{"state":"MD","n":3,"p20":null,"p50":null,"p80":null},{"state":"ME","n":5,"p20":null,"p50":null,"p80":null},{"state":"MI","n":35,"p20":358.6,"p50":687.2,"p80":2638.57},{"state":"MN","n":40,"p20":640.5,"p50":1771.4,"p80":3042.75},{"state":"MO","n":22,"p20":1299.0,"p50":2550.0,"p80":4536.54},{"state":"MS","n":11,"p20":1414.22,"p50":1507.15,"p80":1560.0},{"state":"MT","n":4,"p20":null,"p50":null,"p80":null},{"state":"NC","n":12,"p20":1706.13,"p50":2433.6,"p80":3127.61},{"state":"ND","n":7,"p20":null,"p50":null,"p80":null},{"state":"NE","n":7,"p20":null,"p50":null,"p80":null},{"state":"NH","n":8,"p20":null,"p50":null,"p80":null},{"state":"NJ","n":41,"p20":2099.7,"p50":3986.0,"p80":5181.24},{"state":"NM","n":11,"p20":1645.2,"p50":2408.0,"p80":5095.3},{"state":"NV","n":4,"p20":null,"p50":null,"p80":null},{"state":"NY","n":40,"p20":548.11,"p50":2244.82,"p80":3211.2},{"state":"OH","n":66,"p20":3157.05,"p50":4083.75,"p80":5671.9},{"state":"OK","n":17,"p20":563.47,"p50":563.47,"p80":2862.0},{"state":"OR","n":9,"p20":null,"p50":null,"p80":null},{"state":"PA","n":49,"p20":480.0,"p50":2267.12,"p80":4628.0},{"state":"RI","n":4,"p20":null,"p50":null,"p80":null},{"state":"SC","n":25,"p20":2328.43,"p50":3549.65,"p80":3549.65},{"state":"SD","n":1,"p20":null,"p50":null,"p80":null},{"state":"TN","n":18,"p20":508.66,"p50":1692.91,"p80":2399.22},{"state":"TX","n":59,"p20":583.0,"p50":1138.2,"p80":1853.5},{"state":"UT","n":1,"p20":null,"p50":null,"p80":null},{"state":"VA","n":11,"p20":510.0,"p50":2004.0,"p80":2352.7},{"state":"VT","n":2,"p20":null,"p50":null,"p80":null},{"state":"WA","n":15,"p20":536.9,"p50":984.5,"p80":3192.0},{"state":"WI","n":31,"p20":1489.8,"p50":2369.4,"p80":3154.5},{"state":"WV","n":6,"p20":null,"p50":null,"p80":null},{"state":"WY","n":1,"p20":null,"p50":null,"p80":null}],"by_segment":{"hospital_type":[{"key":"acute","n":770,"p20":753.67,"p50":2186.31,"p80":4327.0},{"key":"childrens","n":12,"p20":null,"p50":null,"p80":null},{"key":"critical_access","n":120,"p20":522.0,"p50":1832.62,"p80":3254.4}],"ownership":[{"key":"for_profit","n":95,"p20":928.0,"p50":1961.0,"p80":4449.81},{"key":"government","n":117,"p20":687.2,"p50":1904.16,"p80":3458.0},{"key":"nonprofit","n":690,"p20":684.0,"p50":2186.27,"p80":4108.0}],"affiliation":[{"key":"affiliated","n":794,"p20":753.67,"p50":2210.8,"p80":4322.5},{"key":"independent","n":113,"p20":535.0,"p50":1557.9,"p80":3273.41}]},"histogram":[{"lo":368.5,"hi":493.22,"n":42},{"lo":493.22,"hi":660.16,"n":77},{"lo":660.16,"hi":883.6,"n":46},{"lo":883.6,"hi":1182.67,"n":63},{"lo":1182.67,"hi":1582.96,"n":77},{"lo":1582.96,"hi":2118.73,"n":106},{"lo":2118.73,"hi":2835.85,"n":132},{"lo":2835.85,"hi":3795.68,"n":121},{"lo":3795.68,"hi":5080.38,"n":76},{"lo":5080.38,"hi":6799.9,"n":77}],"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":"2026-09-05T02:23:05.982663Z","checked_through":"2026-09-25T01:13:52.941847Z","n_priced_setters":3956,"n_filed":655,"n_usable":610,"n_not_usable":0,"n_labelled":16,"n_no_cash":29,"n_estimated":0,"n_states":48,"cash_p10":509.0,"cash_p20":684.0,"cash_p25":870.0,"cash_p50":1853.5,"cash_p75":3341.12,"cash_p80":3570.16,"cash_p90":5222.0,"cash_mean_trimmed":1980.38,"gross_p50":3999.0,"cash_to_gross_p50":0.6,"medicare_rate":null,"medicare_schedule":null,"medicare_year":null,"cash_to_medicare_p50":null,"by_state":[{"state":"AL","n":6,"p20":null,"p50":null,"p80":null},{"state":"AR","n":2,"p20":null,"p50":null,"p80":null},{"state":"AZ","n":3,"p20":null,"p50":null,"p80":null},{"state":"CA","n":61,"p20":1255.95,"p50":2430.4,"p80":4220.73},{"state":"CO","n":13,"p20":1731.6,"p50":2020.2,"p80":3019.5},{"state":"CT","n":3,"p20":null,"p50":null,"p80":null},{"state":"DE","n":1,"p20":null,"p50":null,"p80":null},{"state":"FL","n":20,"p20":1894.4,"p50":2210.8,"p80":2756.6},{"state":"GA","n":24,"p20":1271.7,"p50":1271.7,"p80":4378.0},{"state":"HI","n":5,"p20":null,"p50":null,"p80":null},{"state":"IA","n":18,"p20":558.6,"p50":684.0,"p80":684.0},{"state":"ID","n":7,"p20":null,"p50":null,"p80":null},{"state":"IL","n":16,"p20":392.0,"p50":684.0,"p80":2953.0},{"state":"IN","n":13,"p20":392.0,"p50":396.9,"p80":16658.83},{"state":"KS","n":2,"p20":null,"p50":null,"p80":null},{"state":"KY","n":16,"p20":392.0,"p50":1732.43,"p80":7617.19},{"state":"LA","n":10,"p20":630.42,"p50":975.92,"p80":1195.88},{"state":"MA","n":27,"p20":1689.75,"p50":2517.0,"p80":5629.0},{"state":"MD","n":1,"p20":null,"p50":null,"p80":null},{"state":"ME","n":4,"p20":null,"p50":null,"p80":null},{"state":"MI","n":13,"p20":511.0,"p50":687.2,"p80":1804.06},{"state":"MN","n":35,"p20":1187.55,"p50":1989.39,"p80":3570.16},{"state":"MO","n":15,"p20":1219.2,"p50":1991.4,"p80":2597.4},{"state":"MS","n":4,"p20":null,"p50":null,"p80":null},{"state":"MT","n":3,"p20":null,"p50":null,"p80":null},{"state":"NC","n":5,"p20":null,"p50":null,"p80":null},{"state":"ND","n":7,"p20":null,"p50":null,"p80":null},{"state":"NE","n":5,"p20":null,"p50":null,"p80":null},{"state":"NH","n":8,"p20":null,"p50":null,"p80":null},{"state":"NJ","n":6,"p20":null,"p50":null,"p80":null},{"state":"NM","n":10,"p20":1645.2,"p50":2408.0,"p80":5095.3},{"state":"NV","n":2,"p20":null,"p50":null,"p80":null},{"state":"NY","n":17,"p20":466.0,"p50":548.11,"p80":940.0},{"state":"OH","n":54,"p20":2806.7,"p50":4041.75,"p80":5671.9},{"state":"OK","n":14,"p20":563.47,"p50":563.47,"p80":2050.8},{"state":"OR","n":6,"p20":null,"p50":null,"p80":null},{"state":"PA","n":29,"p20":1285.52,"p50":3414.0,"p80":4628.0},{"state":"RI","n":3,"p20":null,"p50":null,"p80":null},{"state":"SC","n":15,"p20":1816.2,"p50":3549.65,"p80":3549.65},{"state":"SD","n":1,"p20":null,"p50":null,"p80":null},{"state":"TN","n":9,"p20":null,"p50":null,"p80":null},{"state":"TX","n":53,"p20":622.4,"p50":1138.2,"p80":1853.5},{"state":"VA","n":6,"p20":null,"p50":null,"p80":null},{"state":"VT","n":1,"p20":null,"p50":null,"p80":null},{"state":"WA","n":10,"p20":484.9,"p50":984.5,"p80":3384.5},{"state":"WI","n":23,"p20":1489.8,"p50":1489.8,"p80":3154.5},{"state":"WV","n":3,"p20":null,"p50":null,"p80":null},{"state":"WY","n":1,"p20":null,"p50":null,"p80":null}],"by_segment":{"hospital_type":[{"key":"acute","n":501,"p20":687.2,"p50":1853.5,"p80":3570.16},{"key":"childrens","n":9,"p20":null,"p50":null,"p80":null},{"key":"critical_access","n":95,"p20":558.6,"p50":1989.39,"p80":3570.16}],"ownership":[{"key":"for_profit","n":62,"p20":603.2,"p50":1351.4,"p80":4083.75},{"key":"government","n":80,"p20":752.0,"p50":1894.4,"p80":3803.63},{"key":"nonprofit","n":463,"p20":684.0,"p50":1989.39,"p80":3570.16}],"affiliation":[{"key":"affiliated","n":535,"p20":687.2,"p50":1894.4,"p80":3554.2},{"key":"independent","n":75,"p20":480.7,"p50":1417.45,"p80":4220.73}]},"histogram":[{"lo":392.0,"hi":514.01,"n":41},{"lo":514.01,"hi":673.99,"n":48},{"lo":673.99,"hi":883.76,"n":37},{"lo":883.76,"hi":1158.82,"n":48},{"lo":1158.82,"hi":1519.5,"n":59},{"lo":1519.5,"hi":1992.43,"n":62},{"lo":1992.43,"hi":2612.56,"n":74},{"lo":2612.56,"hi":3425.7,"n":68},{"lo":3425.7,"hi":4491.92,"n":62},{"lo":4491.92,"hi":5890.0,"n":55}],"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"}]}