CPT 43236 Surgery - Digestive
Uppr gi scope w/submuc inj Cost
Body System: Digestive
Medicare Facility Rate
$124
CMS PFS CY2026
Medicare Non-Facility Rate
$446
Office/clinic setting
Hospital Outpatient
$927
OPPS rate
Surgery Center (ASC)
$498
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
2.33
Work RVU
1.10
Facility PE RVU
0.27
Malpractice RVU
13.36
Total RVU
Frequently Asked Questions
How much does Uppr gi scope w/submuc inj cost?
The Medicare facility rate is $124. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $927. Ambulatory surgery center rate: $498.
How much does Uppr gi scope w/submuc inj 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 $124.