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See a sample rate comparisonCPT 43266 Fee Schedule
Medicare rates as of October 2026
CPT 43266 is classified under Surgery, in the Surgical Procedures on the Digestive System subgroup.
Esophagogastroduodenoscopy Fl, Esophagogastroduodenoscopy Flexible Transoral With Placement Of Endoscopic Stent (Includes Pre- And Post-Dilation And Guide Wire Passage When Performed)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $192.39 national non-facility rate (2026) · View Medicare rates for 43266 |
| Medicaid Fee Schedule | $155.895 median of the 8 states in the free preview · View Medicaid rates for 43266 |
National average reimbursement for CPT 43266 by major payers:
$284.74
BCBS / Anthem
$310.55
UnitedHealthcare
$318.65
Aetna
$376.50
Cigna
Compare published rates across providers.
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CPT 43266
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Cleburne
$11,871.00Published ratePremier Endoscopy, LLC
Premier Endoscopy LLC
$2,795.00Published rateWomen'S Surgical Center At Northcare, LLC
Women S Surgical Center At Nor
$1,750.00Published ratePhysicians Surgery Center LLC
$965.00Published rateBrooklyn Endoscopy Sc, LLC, Gnyesc
Brooklyn Endoscopy Sc LLC
$432.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 43266 vs. Other Surgical Procedures on the Digestive System Codes
The table lists codes related to 43266. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 43248-CPT | Moderate | Upper Gastrointestinal Endosco, Upper Gastrointestinal Endoscopy Including Esophagusstomach And Either The Duodenum Andor Jejunumas Appropriate With Insertion Of Guide Wire Fol Lowed By |
| 43249-CPT | Moderate | Upper Gastrointestinal Endosco, Upper Gastrointestinal Endoscopy Including Esophagusstomach And Either The Duodenum Andor Jejunumas Appropriate With Balloon Dilation Of Esophag Us (Less Than |
| 43250-CPT | Moderate | Upper Gastrointestinal Endosco, Upper Gastrointestinal Endoscopy Including Esophagusstomach And Either The Duodenum Andor Jejunumas Appropriate With Removal Of Tumor(S) Polyp( S) Or Other |
| 43266-CPT | Moderate | Esophagogastroduodenoscopy Fl, Esophagogastroduodenoscopy Flexible Transoral With Placement Of Endoscopic Stent (Includes Pre- And Post-Dilation And Guide Wire Passage When Performed) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43266. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43266 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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