CPT
43644 — Laparoscopic Roux-en-Y gastric bypass with small intestine reconstruction
Verify the code matches the actual service and dose.
Gastroenterology
43239 — Upper GI endoscopy with biopsy
Upper endoscopy (EGD) with biopsy. Common workup for reflux, ulcers, or upper GI bleeding.
- Typical setting: Outpatient surgical center or hospital
- National avg charge (illustrative): Insurance allowed $700-$2,000 + facility $1,500-$4,500 + anesthesia $400-$1,200.
- Most-disputed reason: OON anesthesia at in-network facility (NSA).
What it means
What 43239 actually means
CPT 43239 is upper GI endoscopy with biopsy — examining the esophagus, stomach, and upper duodenum and taking tissue samples.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Out-of-network anesthesiologist balance billing despite in-network facility (NSA violation).
- Pathology charges out-of-network without proper consent.
- Multiple biopsies billed at full code instead of as part of the procedure.
If you see 43239 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 43239 often also see these adjacent codes on the same bill.
CPT
45378 — Diagnostic colonoscopy
If your screening colonoscopy turned diagnostic, federal rules limit your cost-share.
CPT
45380 — Colonoscopy, flexible, with biopsy, single or multiple
Verify the code matches the actual service and dose.
CPT
45385 — Colonoscopy, flexible, with removal of tumor/polyp/lesion by snare technique
Verify the code matches the actual service and dose.
Related BillBusted guides
Plain-English reads if you see 43239 on a bill.
43239 FAQ
Plain-English answers.
Don't pay 43239 blindly.
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