Price Checker / CPT 43116
CPT 43116 — Partial removal of esophagus
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$4,578
What Medicare pays in a hospital/ASC setting
$4,578
What Medicare pays in a physician's office
$12,368
Based on 11 hospital(s) in our database
What do these numbers mean?
The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.
Hospital Charges for CPT 43116
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Gibson Area Hospital Gibson City, IL | $21,297 | — | 342% |
| Henry Ford Providence Novi Hospital Novi, MI | — | — | 299% |
| Henry Ford Providence Southfield Hospital Southfield, MI | — | — | 299% |
| Valley County Health System Ord, NE | — | — | 200% |
| Illini Community Hospital Pittsfield, IL | — | — | 188% |
| DeSoto Regional Health System , LA | $12,800 | — | 180% |
| Fillmore County Hospital Geneva, NE | — | — | 138% |
| Community Memorial Hospital - Burke Burke, SD | — | — | 72% |
| Broaddus Hospital Association Inc Philippi, WV | — | — | 65% |
| Henry Ford Rochester Hospital Rochester, MI | — | — | 58% |
| Douglas County Memorial Hospital , SD | — | — | 8% |
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About CPT 43116
CPT code 43116 refers to “Partial removal of esophagus”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $4,578 in a facility (hospital or ambulatory surgery center) and $4,578in a non-facility (physician's office) setting.
These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.
What to do if you were overcharged
- Upload your bill— we'll identify this code and compare it against the rates shown above.
- Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
- Negotiate or let us handle it — 25% of savings, no savings = no fee.