How Much Does Egd with Thrml Txmnt Gerd Cost?
Also known as: Egd w/thrml txmnt gerd (CPT 43257)
The total estimated cost of Egd with Thrml Txmnt Gerd (CPT 43257) is $687 to $1,288, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $204.
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 w/thrml txmnt gerd
How to Reduce Your Cost for Egd w/thrml txmnt gerd
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 (6.12) x CF ($33.40) = $204
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Egd w/thrml txmnt gerd cost?
The Medicare facility rate for Egd w/thrml txmnt gerd is $204. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Egd w/thrml txmnt gerd cost without insurance?
Without insurance, the cost of Egd w/thrml txmnt gerd 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 w/thrml txmnt gerd?
Most commercial health insurance plans and Medicare cover Egd w/thrml txmnt gerd 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.