CPT 43241 Surgery - Digestive
Egd tube/cath insertion Cost
Body System: Digestive
Medicare Facility Rate
$127
CMS PFS CY2026
Medicare Non-Facility Rate
$127
Office/clinic setting
Hospital Outpatient
$1
OPPS rate
Surgery Center (ASC)
$894
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
2.43
Work RVU
1.07
Facility PE RVU
0.30
Malpractice RVU
3.80
Total RVU
Frequently Asked Questions
How much does Egd tube/cath insertion cost?
The Medicare facility rate is $127. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $1. Ambulatory surgery center rate: $894.
How much does Egd tube/cath insertion 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 $127.