CPT 43030 Surgery - Digestive
Cricopharyngeal myotomy Cost
Body System: Digestive
Medicare Facility Rate
$467
CMS PFS CY2026
Medicare Non-Facility Rate
$467
Office/clinic setting
Hospital Outpatient
$6
OPPS rate
Surgery Center (ASC)
$3
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
7.79
Work RVU
4.96
Facility PE RVU
1.22
Malpractice RVU
13.97
Total RVU
Frequently Asked Questions
How much does Cricopharyngeal myotomy cost?
The Medicare facility rate is $467. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $6. Ambulatory surgery center rate: $3.
How much does Cricopharyngeal myotomy cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $467.