ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY | Ambulatory Surgery Center | Outpatient Hospital | Physician Services | |||
Code | Procedure Description | ASC Facility Fee (National Medicare Avg) | APC | Facility Fee Schedule (National Medicare Avg)² | Fee When Procedure Performed in Hospital or ASC (National Medicare Avg)³ | Fee When Procedure Performed in Office (National Medicare Avg)³ |
43260 | Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) | $786.01 | 0151 | $1,524.12 | $344.97 | NA* |
43261 | ...with biopsy, single or multiple | $786.01 | 0151 | $1,524.12 | $362.29 | NA* |
43262 | …with sphincterotomy/papillotomy | $786.01 | 0151 | $1,524.12 | $425.08 | NA* |
43263 | ...with pressure measurement of sphincter of Oddi (pancreatic duct or common bile duct) | $786.01 | 0151 | $1,524.12 | $420.02 | NA* |
43264 | …with endoscopic retrograde removal of calculus/calculi from biliary and/or pancreatic ducts | $786.01 | 0151 | $1,524.12 | $510.96 | NA* |
43265 | …with endoscopic retrograde destruction, lithotripsy of calculus/calculi, any method | $786.01 | 0151 | $1,524.12 | $573.75 | NA* |
43267 | ...with endoscopic retrograde insertion of nasobiliary or nasopancreatic drainage tube | $786.01 | 0151 | $1,524.12 | $423.63 | NA* |
43268 | ...with endoscopic retrograde insertion of tube or stent into bile or pancreatic duct | $902.60 | 0384 | $1,785.67 | $430.13 | NA* |
43269 | ...with endoscopic retrograde removal of foreign body and/or change of tube or stent | $902.60 | 0384 | $1,785.67 | $471.99 | NA* |
43271 | ... with endoscopic retrograde balloon dilation of ampulla, biliary and/or pancreatic duct(s) | $786.01 | 0151 | $1,524.12 | $424.72 | NA* |
43272 | ...with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique | $786.01 | 0151 | $1,524.12 | $424.34 | NA* |
Learn about Colonoscopy and Endoscopy billing procedure methodologies. GI gastrointestinal endoscopy and colonoscopy preparation, complication and what happened after the process. How to do the correct billing. EGD, GI and Screening CPT codes.
Sunday, August 1, 2010
ENDOSCOPIC RETROGRADE CPT code and payment
2010 Medicare GI Endoscopy Procedure Reimbursement Guide for ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
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