CPT 43351 Surgery - Digestive

How Much Does Surgical Opening Esophagus Cost?

Also known as: Surgical opening esophagus (CPT 43351)

The total estimated cost of Surgical Opening Esophagus (CPT 43351) is $4,286 to $8,036, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $1,276.

Total Estimated Cost of Care

$4,286 — $8,036

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$1,276
Hospital Facility Fee
$3,827
Anesthesia (est.)
$255
Important: The physician fee of $1,276 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$1,276
Physician component only — CMS PFS 2026

Procedures Commonly Done Together

These procedures are frequently performed alongside Surgical opening esophagus

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How to Reduce Your Cost for Surgical opening esophagus

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.

21.50
Work RVU
11.28
Practice Expense RVU
5.41
Malpractice RVU
38.19
Total RVU

Payment = Total RVU (38.19) x CF ($33.40) = $1,276

Frequently Asked Questions

How much does Surgical opening esophagus cost?

The Medicare facility rate for Surgical opening esophagus is $1,276. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Surgical opening esophagus cost without insurance?

Without insurance, the cost of Surgical opening esophagus 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 Surgical opening esophagus?

Most commercial health insurance plans and Medicare cover Surgical opening esophagus 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.

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