CMS' proposed rate hikes for 10 most common GI procedures

The American College of Gastroenterology, the American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy outlined how reimbursement for the top 10 GI procedures in ASCcs will change under the CMS 2020 proposed rule.

CMS proposes boosting ASC payment rates by 2.7 percent, which would result in an increase in payment for the top 10 GI procedures.

How reimbursement would change:

1. Upper GI endoscopy diagnosis (43235)
Proposed 2020 rate: $395.98
2019 rate: $392.11

2, Upper GI endoscopy, biopsy (43239)
Proposed 2020 rate: $395.98
2019 rate: $392.11

3. Place gastronomy tube (43246)
Proposed 2020 rate: $659.19
2019 rate: $642.40

4. Upper GI endoscopy/guide wire (43248)
Proposed 2020 rate: $395.98
2019 rate:$392.11

5. Esoph endoscopy, dilation (43249)
Proposed 2020 rate:$659.19
2019 rate:$642.40

6. Diagnostic colonoscopy (45378)
Proposed 2020 rate: $385.65
2019 rate: $383.53

7, Colonoscopy and biopsy (45380)
Proposed 2020 rate: $508.57
2019 rate: $504.47

8. Colonoscopy, submucosal injection (45381)
Proposed 2020 rate: $508.57
2019 rate: $504.47

9. Lesion remove colonoscopy (45384)
Proposed 2020 rate: $508.57
2019 rate: $504.47

10. Lesion removal colonoscopy (45385)
Proposed 2020 rate: $508.57
2019 rate: $504.47

A full list of GI procedure reimbursement rates can be found here.

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