How Much Does Esoph Egd Dilation Less than 30 Mm Cost?
Also known as: Esoph egd dilation <30 mm (CPT 43249)
Upper endoscopy with dilation of a narrowed esophagus (esophageal stricture).
The total estimated cost of Esoph Egd Dilation Less than 30 Mm (CPT 43249) is $458 to $858, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $136.
Total Estimated Cost of Care
This estimate includes hospital facility fees, anesthesia, and supplies .
Patient Guide: Esoph Egd Dilation Less than 30 Mm
What you need to know before your appointment
What to Expect
During an upper endoscopy, the doctor uses a balloon or dilators to gently stretch a narrowed area of your esophagus to make swallowing easier.
How Long Does It Take?
20-30 minutes (plus recovery)
Common Reasons Doctors Order This
Difficulty swallowing, food getting stuck, esophageal stricture from acid reflux, radiation, or surgery
How to Prepare
Fast for 6-8 hours. Arrange a driver. Start with soft foods after the procedure. Some soreness when swallowing is normal for a day.
Procedures Commonly Done Together
These procedures are frequently performed alongside Esoph egd dilation <30 mm
How to Reduce Your Cost for Esoph egd dilation <30 mm
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
For this procedure, the office rate ($1,180) differs from the facility rate ($136). Ask if it can be done in an office setting.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (35.34) x CF ($33.40) = $1,180
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Esoph egd dilation <30 mm cost?
The Medicare facility rate for Esoph egd dilation <30 mm is $136. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Esoph egd dilation <30 mm cost without insurance?
Without insurance, the cost of Esoph egd dilation <30 mm can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Esoph egd dilation <30 mm?
Most commercial health insurance plans and Medicare cover Esoph egd dilation <30 mm when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.