Price Checker / CPT 43204
CPT 43204 — Esoph scope w/sclerosis inj
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$121
What Medicare pays in a hospital/ASC setting
$121
What Medicare pays in a physician's office
$3,793
Based on 7 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 43204
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| "Connecticut Children's Medical Center" , CT | $7,289 | $4,374 | 5945% |
| Park Place Surgical Hospital , LA | $5,076 | $1,510 | 4110% |
| Haskell Regional Hospital , OK | $4,672 | $4,672 | 3775% |
| Monroe Regional Hospital , MS | $4,672 | $4,672 | 3775% |
| Mosaic Medical Center in Maryville , MO | $4,600 | $3,910 | 3715% |
| Henry Ford Rochester Hospital , MI | — | — | 100% |
| South Brooklyn Health Brooklyn, NY | — | — | -100% |
Were you billed for this procedure?
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About CPT 43204
CPT code 43204 refers to “Esoph scope w/sclerosis inj”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $121 in a facility (hospital or ambulatory surgery center) and $121in 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.