Upper Endoscopy With Drainage Of A Fluid Pocket

Nationwide rates for HCPCS 43240

An examination of the food pipe, stomach and first part of the small intestine with a flexible scope, during which a fluid collection pressing against the stomach or intestinal wall — most often a pocket left behind after inflammation of the pancreas — is drained. The doctor makes an opening through the wall into the collection and leaves one or more short tubes in place so it empties into the gut. Ultrasound from the tip of the scope is normally used to find a safe route.

Rates data updated July 2026.

How much does Upper Endoscopy With Drainage Of A Fluid Pocket cost?

$3,901

Typical total for the visit. Nationwide, July 2026.

Insurers have agreed to pay about $3,901 for this procedure. That total is two separate charges: $513 to the doctor who performs it, and $3,388 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

13% physician fee87% facility fee

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 57 insurance carriers under federal price transparency rules.

What's inside this number

Part of the bill	Who charges it	Typical	Range
Physician feeThe doctor who performs it	The doctor who performs it	$513	$380 to $813
Facility feeThe hospital or surgery center	The hospital or surgery center	$3,388	$1,148 to $6,026

How much rates vary

Facilitymedian $3,388 · 10th to 90th $513 to $10,471Professionalmedian $513 · 10th to 90th $339 to $1,549

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier Global Typical Low $660.69 Median $3,467.37 Typical High $9,332.54	Facility	Global	$660.69	$3,467.37	$9,332.54
BCBS Setting Facility Modifier Global Typical Low $1,584.89 Median $4,570.88 Typical High $13,489.63	Facility	Global	$1,584.89	$4,570.88	$13,489.63
Cigna Setting Facility Modifier Global Typical Low $512.86 Median $1,174.90 Typical High $6,165.95	Facility	Global	$512.86	$1,174.90	$6,165.95
United Setting Facility Modifier Global Typical Low $1,023.29 Median $4,265.80 Typical High $11,220.18	Facility	Global	$1,023.29	$4,265.80	$11,220.18

What it costs in each state

The same service costs 6.6 times more in Wisconsin than in Virginia. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility fee

WI $7,420VA $1,123

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.