CPT 43860 Surgery - Digestive

How Much Does Revision Gstr/jj Anast without Vgtmy Cost?

Also known as: Revj gstr/jj anast w/o vgtmy (CPT 43860)

Revision Gstr/jj Anast without Vgtmy (CPT 43860) costs $1,516 at Medicare rates.

Medicare (Facility)
$1,516
CMS PFS 2026 national rate

Procedures Commonly Done Together

These procedures are frequently performed alongside Revj gstr/jj anast w/o vgtmy

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How to Reduce Your Cost for Revj gstr/jj anast w/o vgtmy

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

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 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.

27.19
Work RVU
11.29
Practice Expense RVU
6.91
Malpractice RVU
45.39
Total RVU

Payment = Total RVU (45.39) x CF ($33.40) = $1,516

Frequently Asked Questions

How much does Revj gstr/jj anast w/o vgtmy cost?

The Medicare facility rate for Revj gstr/jj anast w/o vgtmy is $1,516. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Revj gstr/jj anast w/o vgtmy cost without insurance?

Without insurance, the cost of Revj gstr/jj anast w/o vgtmy 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 Revj gstr/jj anast w/o vgtmy?

Most commercial health insurance plans and Medicare cover Revj gstr/jj anast w/o vgtmy 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.

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