ERCP, diagnostic including collection of specimens (CPT code 43260)
RVUs:
• Work: 5.95
• Total Office: 9.84
• Total Facility: 9.84
Reimbursement:
• Physician office: $352
• Physician facility: $352
• HOPD: $1,934
• ASC: $1,068
ERCP with biopsy, single or multiple (CPT code 43261)
RVUs:
• Work: 6.25
• Total Office: 10.32
• Total Facility: 10.32
Reimbursement:
• Physician office: $370
• Physician facility: $370
• HOPD: $1,934
• ASC: $1,068
ERCP with sphincterotomy/papillotomy (CPT code 43262)
RVUs:
• Work: 6.60
• Total Office: 10.89
• Total Facility: 10.89
Reimbursement:
• Physician office: $390
• Physician facility: $390
• HOPD: $1,934
• ASC: $1.068
ERCP with pressure measurement of sphincter of Oddi (CPT code 43263)
RVUs:
• Work: 6.60
• Total Office: 10.90
• Total Facility: 10.90
Reimbursement:
• Physician office: $390
• Physician facility: $390
• HOPD: $1,934
• ASC: $1,068
ERCP with removal of debris from biliary/pancreatic ducts (CPT code 43264)
RVUs:
• Work: 6.73
• Total Office: 11.10
• Total Facility: 11.10
Reimbursement:
• Physician office: $398
• Physician facility: $398
• HOPD: $1,934
• ASC: $1,068
ERCP with destruction of calculi (CPT code 43265)
RVUs:
• Work: 8.03
• Total Office: 13.18
• Total Facility: 13.18
Reimbursement:
• Physician office: $472
• Physician facility: $472
• HOPD: $1,934
• ASC: $1,068
ERCP with transendoscopic balloon dilation of biliary/pancreatic ducts (CPT code 43277)
RVUs:
• Work: 7.0
• Total Office: 11.54
• Total Facility: 11.54
Reimbursement:
• Physician office: $413
• Physician facility: $413
• HOPD: $1,934
• ASC: $1,068
ERCP with ablation of tumors, polyps or lesions
RVUs:
• Work: 7.99
• Total Office: 13.12
• Total Facility: 13.12
Reimbursement:
• Physician office: $470
• Physician facility: $470
• HOPD: $1,934
• ASC: $1,068
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