CPT 43198 Surgery - Digestive
Esophagosc flex trnsn biopsy Cost
Body System: Digestive
Medicare Facility Rate
$82
CMS PFS CY2026
Medicare Non-Facility Rate
$218
Office/clinic setting
Hospital Outpatient
$927
OPPS rate
Surgery Center (ASC)
$151
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
1.77
Work RVU
0.43
Facility PE RVU
0.25
Malpractice RVU
6.53
Total RVU
Frequently Asked Questions
How much does Esophagosc flex trnsn biopsy cost?
The Medicare facility rate is $82. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $927. Ambulatory surgery center rate: $151.
How much does Esophagosc flex trnsn biopsy 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 $82.