Price Checker / CPT 43265
How much does Ercp Lithotripsy Calculi cost?
CPT 43265 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 18x the fair price — among the most extreme markups. Dispute this.
Fair price
$570–$1,150
What this should cost
With insurance
~$3,500
Typical out-of-pocket
Overcharged if over
$1,450
Push back above this
The average hospital charge of $15,243 is $14,383 over the fair price (about 18x the fair rate).
What hospitals charge for Ercp Lithotripsy Calculi
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Memorial Medical Center PORT LAVACA, NM | $47,677 | — | 12555% |
| Mosaic Medical Center in Maryville , MO | $15,000 | $12,750 | 3881% |
| Avita Ontario Hospital Ontario, OH | $13,311 | — | 3150% |
| Bucyrus Community Hospital Bucyrus, OH | $13,311 | — | 3150% |
| Galion Community Hospital GALION, OH | $13,311 | — | 3150% |
| University Hospitals Samaritan Medical Center ASHLAND, OH | $11,767 | $8,825 | 3023% |
| Madison Medical Center Fredericktown, MO | $4,366 | — | 1257% |
| "Doctors' Center Hospital - San Fernando de la Carolina" , DE | $3,200 | $3,200 | 749% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Ercp Lithotripsy Calculi
CPT code 43265 refers to ercp lithotripsy calculi (billing description: "Ercp lithotripsy calculi"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $377 in a facility (hospital or surgery center) and $377 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.