There is no single endoscopy CPT code. The correct code depends entirely on the endoscopy type and what was performed during the procedure.
Using the wrong code or a code that does not match the operative report results in a denied claim or a compliance flag.
This guide covers the full landscape of endoscopy CPT codes for 2026. Here is what it walks through:
- 2026 CPT updates and common coding FAQs.
- Capsule, nasal endoscopy, and ERCP coding guidance.
- Colonoscopy codes (45378–45398), G-codes, and modifiers.
- EGD CPT codes (43235–43259) for diagnostic and therapeutic procedures.
- Endoscopy code table with primary and biopsy CPT codes.
- Sedation (99151–99157) and anesthesia billing.
What are the CPT codes for upper endoscopy (EGD)?
EGD, esophagogastroduodenoscopy, uses the code range 43235 to 43259. Code selection is driven by what was done during the procedure, not just that an EGD was performed.
The upper GI endoscopy CPT code range covers exam only, biopsy, dilation, bleeding control, polypectomy, mucosal resection, stent placement, and ablation.
Bill the most definitive procedure performed. Do not unbundle component codes when a single comprehensive code applies.
| CPT code | Description | Notes |
| 43235 | Diagnostic EGD, including brushing/washing | Bill when exam only, no biopsy, no intervention |
| 43239 | EGD with biopsy, single or multiple | One code regardless of biopsy count |
| 43245 | EGD with dilation of gastric outlet | Use for pyloric/duodenal stricture dilation |
| 43248 | EGD with transendoscopic tube placement | Guidewire-assisted; different from 43246 |
| 43249 | EGD with balloon dilation <30mm | Esophageal dilation; see 43458 for 30mm+ |
| 43250 | EGD with hot biopsy forceps | Polypectomy via hot forceps |
| 43251 | EGD with snare polypectomy | Use for sessile/pedunculated polyps |
| 43254 | EGD with EMR | Endoscopic mucosal resection |
| 43255 | EGD with hemorrhage control | Injection, coagulation, or clips |
| 43266 | EGD with stent placement | Replaced deleted 43256 effective 2014 |
| 43270 | EGD with ablation | Replaced deleted 43258; covers BARRX, APC |
Diagnostic EGD
CPT 43235 is the base code for a diagnostic upper endoscopy.
It covers the examination of the esophagus, stomach, and duodenum, and includes any brushings or washings performed during the same session. Bill 43235 when the procedure is examined only with no biopsy or intervention.
EGD with biopsy
CPT 43239 covers endoscopy with biopsy CPT work, whether one specimen or several are taken.
The code does not increment with biopsy count. Bill 43239, not 43235, any time tissue is obtained, regardless of the number of samples.
Therapeutic EGD
Therapeutic codes replace 43235, do not stack a diagnostic code on top. For dilation, use 43245 (gastric outlet), 43249 (balloon <30mm), or 43248 (tube placement).
For bleeding control, use 43255. For polypectomy, use 43250 (hot forceps) or 43251 (snare). EMR is reported as 43254. Stent placement uses 43266 and ablation uses 43270.
What are the CPT codes for colonoscopy?
Colonoscopy codes fall in the 45378 to 45398 range for standard diagnostic and therapeutic procedures. Screening colonoscopies use separate G-codes under CMS rules.
The distinction between screening and diagnostic affects both code selection and patient cost-sharing. Key codes are summarized below:
| CPT / HCPCS code | Description | Use case |
| 45378 | Diagnostic colonoscopy, no intervention | Standard diagnostic exam |
| 45380 | Colonoscopy with biopsy | One code for all biopsies taken |
| 45381 | Colonoscopy with submucosal injection | Injection to lift or mark lesion |
| 45385 | Colonoscopy with snare polypectomy | Hot or cold snare; most common interventional |
| 45388 | Colonoscopy with ablation | Laser, APC, or other ablation |
| 45398 | Colonoscopy with balloon dilation | Stricture dilation |
| G0105 | Screening colonoscopy, high risk | Personal history of polyps/colorectal disease |
| G0121 | Screening colonoscopy, average risk | Routine screening; not high risk |
When a screening colonoscopy converts to diagnostic (polyp found and removed), bill the appropriate therapeutic code (e.g., 45385) with modifier PT to signal the screening intent to the payer.
Modifier 33 is used for preventive services under commercial plans that fall under ACA rules.
What is the CPT code for capsule endoscopy?
CPT 91110 covers capsule endoscopy of the small bowel, including image acquisition, review, and interpretation. CPT 91111 covers esophageal capsule endoscopy.
These are the only two capsule codes, do not bill a technical and professional component separately unless your payer contract explicitly requires it.
CMS LCD L36704 governs coverage criteria for capsule studies. If the ileum is not visualized due to capsule retention or battery failure, append modifier 52 (reduced service) to 91110.
Document the reason clearly in the report, payers audit this modifier frequently on capsule endoscopy CPT claims.
What is the CPT code for nasal endoscopy?
CPT 31231 is the diagnostic nasal endoscopy CPT code. It covers unilateral or bilateral diagnostic examination of the nasal cavity.
Surgical nasal endoscopy codes start at 31233 and extend through 31298, covering procedures such as sinusotomy, polypectomy, and turbinate reduction.
| CPT code | Description |
| 31231 | Diagnostic nasal endoscopy |
| 31233 | Nasal endoscopy with maxillary sinusotomy |
| 31235 | Nasal endoscopy with sphenoid sinusotomy |
| 31237 | Nasal endoscopy with biopsy, polypectomy, or debridement |
| 31240 | Nasal endoscopy with concha bullosa resection |
31231 cannot be billed with a surgical nasal endoscopy code on the same side on the same date, the diagnostic component is bundled into the surgical procedure.
Check the NCCI edits before billing any nasal endoscopy combination.
What are the CPT codes for ERCP?
ERCP, endoscopic retrograde cholangiopancreatography, uses codes 43260 to 43278.
These codes are procedure-specific. Bill only what was performed and document the extent of the procedure in the operative report.
| CPT code | Description |
| 43260 | ERCP, diagnostic [collection of specimen(s)] |
| 43261 | ERCP with biopsy |
| 43262 | ERCP with sphincterotomy |
| 43264 | ERCP with removal of calculi |
| 43265 | ERCP with lithotripsy of calculi |
| 43274 | ERCP with stent placement |
| 43278 | ERCP with ablation of tumor(s) |
Multiple interventions during a single ERCP session may be billable. However, NCCI bundling rules apply.
For example, 43262 (sphincterotomy) is bundled into 43264 (stone removal), bill the stone removal code only. Review the current ERCP CPT code NCCI edit table before submitting combined claims.
How should sedation be billed with endoscopy?
Sedation for endoscopy has been billed separately since January 2017.
Moderate sedation codes 99151 to 99157 apply when the endoscopist administers and monitors sedation personally.
Anesthesia codes apply when a separate anesthesia provider is present.
| Code | Description |
| 99151 | Moderate sedation, same physician, patient under 5 years, first 15 min |
| 99152 | Moderate sedation, same physician, patient 5+ years, first 15 min |
| 99153 | Each additional 15 minutes (add-on to 99151/99152) |
| 99155 | Moderate sedation, different physician, patient under 5 years, first 15 min |
| 99156 | Moderate sedation, different physician, patient 5+ years, first 15 min |
| 99157 | Each additional 15 minutes (add-on to 99155/99156) |
| G0500 | Moderate sedation, same physician, Medicare (first 15 minutes) |
| 00731 | Anesthesia for upper GI endoscopy |
| 00811 | Anesthesia for diagnostic lower GI endoscopy |
| 00812 | Anesthesia for screening colonoscopy |
| 00813 | Anesthesia for combined upper and lower GI endoscopy |
Monitored anesthesia care (MAC) uses the 004xx anesthesia code series.
Do not bill a moderate sedation code and a separate anesthesia code for the same encounter.
When a CRNA or anesthesiologist is involved, the 00xxx codes apply and the endoscopist does not bill sedation separately.
What changed in endoscopy CPT codes for 2026?
Here’s a rundown on what changed and what stayed same for endoscopy CPT codes:
Still seeing endoscopy claim denials or underpayments?
Endoscopy billing goes beyond selecting the right CPT code. Modifier selection, multiple endoscopy payment rules, sedation vs. anesthesia coding, NCCI edits, and payer-specific policies all affect whether a claim is paid correctly the first time.
MedHeave’s GI billing specialists help practices:
- Assign the correct EGD, colonoscopy, ERCP, capsule, and endoscopy CPT codes.
- Apply modifiers correctly for screening, therapeutic procedures, and anesthesia.
- Reduce denials caused by bundling edits, documentation gaps, and payer-specific rules.
- Maximize reimbursement while maintaining full coding compliance.
Schedule a free endoscopy billing assessment with MedHeave and see where your revenue cycle can improve.
Frequently asked questions
Here are some commonly asked questions on this topic:
CPT 43235 is the most frequently billed CPT code upper endoscopy. It covers a diagnostic EGD with no biopsy or intervention. CPT 43239 is the next most common, used whenever a biopsy is obtained during the same session.
Yes. CPT 43239 covers EGD with a single biopsy or multiple biopsies taken at the same session. The code does not change based on the number of biopsy samples. Bill 43239 any time tissue is obtained during an upper endoscopy, and do not report 43235 alongside it.
Esophagoscopy codes (43180 to 43233) cover the esophagus only. EGD codes (43235 to 43259) cover the esophagus, stomach, and duodenum. Bill the esophagoscopy range only when the examination is intentionally limited to the esophagus and the duodenum and stomach are not examined.
Yes, both procedures can be billed on the same date of service when medically necessary. The multiple endoscopy payment rule may reduce reimbursement for the secondary procedure, depending on payer policy. For anesthesia, use 00813, the code for combined upper and lower GI endoscopy on the same date.
