How Much Does Ercp with Specimen Collection Cost?
Also known as: Ercp w/specimen collection (CPT 43260)
ERCP (endoscopic retrograde cholangiopancreatography) - a specialized endoscopy to examine and treat bile duct and pancreatic duct problems.
The total estimated cost of Ercp with Specimen Collection (CPT 43260) is $944 to $1,769, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $281.
Total Estimated Cost of Care
This estimate includes hospital facility fees, anesthesia, and supplies .
Patient Guide: Ercp with Specimen Collection
What you need to know before your appointment
What to Expect
Under deep sedation, a special endoscope is passed through the mouth to the opening of the bile and pancreatic ducts. Dye is injected and X-rays taken. The doctor can remove stones, place stents, or take biopsies.
How Long Does It Take?
30-90 minutes (plus recovery)
Common Reasons Doctors Order This
Bile duct stones, bile duct obstruction, pancreatitis evaluation, bile duct cancer, jaundice workup
How to Prepare
Fast for 6-8 hours. Arrange a driver. Tell the doctor about all medications, especially blood thinners. You may stay overnight for monitoring.
Procedures Commonly Done Together
These procedures are frequently performed alongside Ercp w/specimen collection
How to Reduce Your Cost for Ercp w/specimen collection
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 (8.41) x CF ($33.40) = $281
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Ercp w/specimen collection cost?
The Medicare facility rate for Ercp w/specimen collection is $281. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Ercp w/specimen collection cost without insurance?
Without insurance, the cost of Ercp w/specimen collection 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 Ercp w/specimen collection?
Most commercial health insurance plans and Medicare cover Ercp w/specimen collection 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.