Gastroenterology · Mississippi

Gastroenterology commercial reimbursement in Mississippi

How Mississippi gastroenterology rates compare with the national market.

Gastroenterology in Mississippi

36 codes · 93 sampled providers
Index vs national
115
15% above
Rank among states
13 of 50
1 = highest
Codes above national
24 of 36
median code at 117%
Providers
93
sampled

What the data shows

1

Gastroenterology ranks 13th of 50 states in Mississippi with an index of 115 (100 = the specialty's national median), across 36 codes and 93 sampled providers.

2

Of the 36 gastroenterology codes with enough data in Mississippi, 24 pay above the national median and 12 below; the typical code sits at 117% of the national median.

3

Largest premium over the national median: CPT 43235 (Egd diagnostic brush wash) at 141%; largest discount: CPT 99490 (Chrnc care mgmt staff 1st 20) at 82%.

4

Measured against Medicare, Mississippi gastroenterology rates have a median of 220% of the Medicare rate across these codes.

Codes above and below the national median

The five largest gaps in each direction

Highest vs national

CodeMississippNationalGapProv.
43235
Egd diagnostic brush wash
$414$294+41%92
43249
Esoph egd dilation <30 mm
$376$271+39%92
45388
Colonoscopy w/ablation
$663$492+35%92
45390
Colonoscopy w/resection
$714$532+34%92
45378
Diagnostic colonoscopy
$536$408+31%92

Lowest vs national

CodeMississippNationalGapProv.
99490
Chrnc care mgmt staff 1st 20
$49$60-18%91
99212
Office o/p est sf 10 min
$43$51-16%93
99215
Office o/p est hi 40 min
$155$185-16%92
99213
Office o/p est low 20 min
$76$90-16%93
99205
Office o/p new hi 60 min
$213$252-15%92

All gastroenterology codes in Mississippi

Median across payers vs the specialty's national median and the Medicare rate; sorted by premium
CodeMississippiNationalGap% of MedicareProvidersTINsLevel
CPT 43235
Egd diagnostic brush wash
$414$294+41%374%92112
CPT 43249
Esoph egd dilation <30 mm
$376$271+39%276%92112
CPT 45388
Colonoscopy w/ablation
$663$492+35%278%92108
CPT 45390
Colonoscopy w/resection
$714$532+34%246%92106
CPT 45378
Diagnostic colonoscopy
$536$408+31%325%92113
CPT 43255
Egd control bleeding any
$595$459+30%336%92111
CPT 45385
Colonoscopy w/lesion removal
$718$556+29%321%92113
CPT 43239
Egd biopsy single/multiple
$450$349+29%364%92113
CPT 43264
Ercp remove duct calculi
$799$622+28%252%92112
CPT 45380
Colonoscopy and biopsy
$603$470+28%339%92112
CPT 43274
Ercp duct stent placement
$939$739+27%234%92110
CPT 45384
Colonoscopy w/lesion removal
$653$519+26%321%92111
CPT 43248
Egd guide wire insertion
$455$364+25%307%92111
CPT 43246
Egd place gastrostomy tube
$419$338+24%235%92113
CPT 43238
Egd us fine needle bx/aspir
$470$383+23%230%91110
CPT 43237
Endoscopic us exam esoph
$380$318+19%220%92110
CPT 88313
Special stains group 2
$84$71+19%104%92111
CPT 43251
Egd remove lesion snare
$496$425+17%287%92111
CPT 43259
Egd us exam duodenum/jejunum
$443$384+15%223%92111
CPT 20610
Drain/inj joint/bursa w/o us
$96$84+14%139%90108
CPT 88312
Special stains group 1
$113$99+14%103%92111
CPT 88305
Tissue exam by pathologist
$81$71+14%116%92111
CPT 43276
Ercp stent exchange w/dilate
$859$771+11%205%92109
CPT 93000
Electrocardiogram complete
$27$25+8%178%90108
CPT 43242
Egd us fine needle bx/aspir
$430$454-5%187%92110
CPT 46221
Ligation of hemorrhoid(s)
$323$346-7%99%92111
CPT 91110
Gi trc img intral esoph-ile
$1,078$1,175-8%134%92111
CPT 99203
Office o/p new low 30 min
$111$124-11%94%92112
CPT 99204
Office o/p new mod 45 min
$170$194-12%96%92112
CPT 96413
Chemo iv infusion 1 hr
$179$204-12%134%92109
CPT 99214
Office o/p est mod 30 min
$112$132-15%83%93114
CPT 99205
Office o/p new hi 60 min
$213$252-15%90%92111
CPT 99213
Office o/p est low 20 min
$76$90-16%80%93114
CPT 99215
Office o/p est hi 40 min
$155$185-16%81%92114
CPT 99212
Office o/p est sf 10 min
$43$51-16%72%93115
CPT 99490
Chrnc care mgmt staff 1st 20
$49$60-18%74%91107

Frequently asked questions

How do Mississippi gastroenterology rates compare with the rest of the country?

Mississippi ranks 13th of 50 states with an index of 115; 24 of 36 codes are above the national median.

Which gastroenterology code has the biggest premium in Mississippi?

CPT 43235 (Egd diagnostic brush wash), at 141% of the national median.

Are these Medicare or commercial rates?

Commercial in-network negotiated rates from four national payers' published files; the Medicare comparison column uses the CY2026 Medicare physician fee schedule.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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