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What the whole ERCP (bile duct endoscopy) costs

Endoscopy of the bile and pancreatic ducts: stone removal (43264), sphincterotomy (43262) or stent placement (43274). Every bill that usually comes with it, who sends it, and where each number comes from.

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Medicare, national amounts, 2026

BillSurgery centerHospital outpatient
Facility$1,987$3,939
Surgeon$317$317
Anesthesia$232$232
Before surgery (typical)$177$177
Total$2,713$4,665

National Medicare amounts (payment-area and wage adjustments at 1.0). Facility: OPPS Addendum B, July 2026 (national unadjusted rate); local = rate × (0.6 × wage index + 0.4); ASC Addendum AA, July 2026 (national rate); local = rate × (0.5 × wage index + 0.5); device-intensive (J8) codes keep the device portion unadjusted; FY 2026 IPPS final rule CMS-1833-F, Table 5; standard amounts from Tables 1A-1E; local = weight × (labor × wage index + non-labor + capital × wage index^0.6848). Leaves out teaching (IME), safety-net (DSH) and outlier add-ons. Surgeon: CMS Physician Fee Schedule CY2026 (RVU26D). Anesthesia: CMS base units × the CY2026 anesthesia conversion factor, with an assumed case time. An educational estimate, not a quote.

Line by line (surgery center)

Questions

How much does a ERCP (bile duct endoscopy) cost in total, with every bill?

At national Medicare rates for 2026, the whole ERCP (bile duct endoscopy) comes to about $2,713 in a surgery center and about $4,665 in a hospital outpatient, counting the facility, the surgeon, anesthesia and typical care before and after. Commercial plans usually pay more; local rates differ by area.

Why do I get separate bills for a ERCP (bile duct endoscopy)?

The surgery center bills for the facility; the surgeon's group bills for the operation (Surgeon, CPT 43264, about $317 from Medicare nationally); the anesthesia group bills by base units plus time (about $232 at our default time); labs, imaging, pathology and therapy each come from their own provider.

What does the surgeon's fee include?

Same-day global: covers the procedure day only.