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CPT 43264Medical Service

Removal of Stone or Debris From Bile or Pancreatic Duct using a Flexible Endoscope

Removal of stone or debris from bile or pancreatic duct using a flexible endoscope. Clinical pricing breakdown and utilization metrics across 1,348 practicing doctors nationwide.

$1488.00
Peer Median Charge
Gross billed rate
$149.07
Standard Baseline
Customary allowable
10.0x
National Markup
Charge vs baseline
1,348
Active Physicians
Billing this code
Planning care or already received a bill for CPT 43264?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $1488.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $149.07 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:
  • "Does Dr. [Name] participate in my specific insurance plan network?"
  • "What is the total self-pay or cash rate for code 43264 if paid upfront?"
  • "Are there separate facility, anesthesia, or pathology fees associated with this procedure?"