Gastroenterology in the ASC: Endoscopy CPT Codes and Billing Reference
Gastroenterology is one of the most common specialties in ambulatory surgery centers and office-based labs, mostly diagnostic and therapeutic endoscopy: passing a flexible scope through the GI tract to look at tissue, take biopsies, remove polyps, and treat bleeding.
The relevant CPT codes fall in the endoscopy range 43200 to 45999, covering upper GI work like EGD code 43235 and lower GI work like 45378 (Diagnostic colonoscopy). Coverage follows the CMS addenda: codes on Addendum AA are on the ASC Covered Procedures List, meaning Medicare pays them when performed in an ASC, while Addendum EE lists procedures excluded from ASC payment. Coders should confirm the current-year status rather than assume. DataLily's procedure library tracks CPT-specific prior-authorization and documentation requirements across this range.
Gastroenterology codes(1–60 of 392)
- 45378Diagnostic colonoscopy
- 45380Colonoscopy and biopsy
- 43239Egd biopsy single/multiple
- 43235Egd diagnostic brush wash
- 43200Esophagoscopy flexible brush
- 43201Esoph scope w/submucous inj
- 43202Esophagoscopy flex biopsy
- 43204Esoph scope w/sclerosis inj
- 43205Esophagus endoscopy/ligation
- 43206Esoph optical endomicroscopy
- 43210Egd esophagogastrc fndoplsty
- 43211Esophagoscop mucosal resect
- 43212Esophagoscop stent placement
- 43213Esophagoscopy retro balloon
- 43214Esophagosc dilate balloon 30
- 43215Esophagoscopy flex remove fb
- 43216Esophagoscopy lesion removal
- 43217Esophagoscopy snare les remv
- 43220Esophagoscopy balloon <30mm
- 43226Esoph endoscopy dilation
- 43227Esophagoscopy control bleed
- 43229Esophagoscopy lesion ablate
- 43231Esophagoscop ultrasound exam
- 43232Esophagoscopy w/us needle bx
- 43233Egd balloon dil esoph30 mm/>
- 43236Uppr gi scope w/submuc inj
- 43237Endoscopic us exam esoph
- 43238Egd us fine needle bx/aspir
- 43240Egd w/transmural drain cyst
- 43241Egd tube/cath insertion
- 43242Egd us fine needle bx/aspir
- 43243Egd injection varices
- 43244Egd varices ligation
- 43245Egd dilate stricture
- 43246Egd place gastrostomy tube
- 43247Egd remove foreign body
- 43248Egd guide wire insertion
- 43249Esoph egd dilation <30 mm
- 43250Egd cautery tumor polyp
- 43251Egd remove lesion snare
- 43252Egd optical endomicroscopy
- 43253Egd us transmural injxn/mark
- 43254Egd endo mucosal resection
- 43255Egd control bleeding any
- 43257Egd w/thrml txmnt gerd
- 43259Egd us exam duodenum/jejunum
- 43260Ercp w/specimen collection
- 43261Endo cholangiopancreatograph
- 43262Endo cholangiopancreatograph
- 43263Ercp sphincter pressure meas
- 43264Ercp remove duct calculi
- 43265Ercp lithotripsy calculi
- 43266Egd endoscopic stent place
- 43270Egd lesion ablation
- 43273Endoscopic pancreatoscopy
- 43274Ercp duct stent placement
- 43275Ercp remove forgn body duct
- 43276Ercp stent exchange w/dilate
- 43277Ercp ea duct/ampulla dilate
- 43278Ercp lesion ablate w/dilate
Are gastroenterology procedures done in an ASC?
Yes. Diagnostic and therapeutic endoscopy, including colonoscopy and EGD, is among the most common work done in ambulatory surgery centers and office-based labs. These are short, scheduled procedures reported with place of service 24 for an ASC or 11 for an office. Whether a specific code is payable in an ASC depends on the CMS addendum it sits on, with Addendum AA codes being on the ASC Covered Procedures List.
What CPT codes does gastroenterology use?
Gastroenterology endoscopy codes fall in the CPT range 43200 to 45999. Upper GI exams use EGD codes such as 43235 (Egd diagnostic brush wash) and 43239 (Egd biopsy single or multiple). Lower GI exams use colonoscopy codes such as 45378 (Diagnostic colonoscopy) and 45380 (Colonoscopy and biopsy), along with sigmoidoscopy and related codes.
What is the difference between a diagnostic and a biopsy endoscopy code?
A diagnostic code describes the base scope exam without tissue removal, for example 45378 for a diagnostic colonoscopy or 43235 for a diagnostic EGD with brushing or washing. When the physician takes tissue during the same session, a biopsy code applies instead, such as 45380 for colonoscopy with biopsy or 43239 for EGD with single or multiple biopsies. Code selection should reflect what was actually performed and documented.