CPT 43249 Surgery - Digestive
Esoph egd dilation <30 mm Cost
Body System: Digestive
Medicare Facility Rate
$136
CMS PFS CY2026
Medicare Non-Facility Rate
$1,180
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)
2.60
Work RVU
1.18
Facility PE RVU
0.30
Malpractice RVU
35.34
Total RVU
Frequently Asked Questions
How much does Esoph egd dilation <30 mm cost?
The Medicare facility rate is $136. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $1. Ambulatory surgery center rate: $894.
How much does Esoph egd dilation <30 mm 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 $136.