How Much Does Egd US Fine Needle Biopsy/aspir Cost?
Also known as: Egd us fine needle bx/aspir (CPT 43242)
The total estimated cost of Egd US Fine Needle Biopsy/aspir (CPT 43242) is $772 to $1,448, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $230.
Total Estimated Cost of Care
This estimate includes hospital facility fees, anesthesia, and supplies .
Procedures Commonly Done Together
These procedures are frequently performed alongside Egd us fine needle bx/aspir
How to Reduce Your Cost for Egd us fine needle bx/aspir
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (6.88) x CF ($33.40) = $230
Related Procedures
Similar procedures in the same category or body system
People Also Ask
Common questions people search for about this procedure
Does insurance cover endoscopic ultrasound?
If you have medical insurance, your plan may cover a portion of the cost of your EUS, but it's essential to verify with your provider beforehand. In addition, the type of EUS performed will impact the cost. Diagnostic EUS, typically a simpler procedure, is often less expensive than the more complex interventional EUS.
Why would a doctor order an endoscopic ultrasound?
Doctors use EUS to look for cancer, inflammation, noncancerous tumors, cysts, blood vessel problems, lymph node issues, and more. An endoscopic ultrasound can help doctors diagnose and stage: Esophageal cancer.
Is there a prep for an endoscopic ultrasound?
What are the disadvantages of endoscopic ultrasound?
The major complications associated with EUS-FNA include hemorrhage, perforation, infection, and organ-specific complications, such as acute pancreatitis after puncture for pancreatic lesions.
Frequently Asked Questions
How much does Egd us fine needle bx/aspir cost?
The Medicare facility rate for Egd us fine needle bx/aspir is $230. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Egd us fine needle bx/aspir cost without insurance?
Without insurance, the cost of Egd us fine needle bx/aspir can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Egd us fine needle bx/aspir?
Most commercial health insurance plans and Medicare cover Egd us fine needle bx/aspir when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.