CPT 43245

Egd Dilation Gastric/Duodenal Stricture

CPT 43245 pays $654.99 in a non-facility setting and $156.98 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $571.94 in Arkansas to $758.24 in District of Columbia, a 33% spread.

National non-facility rate

$654.99

Office and other outpatient settings

Facility rate
$156.98

Hospital and ASC settings

Highest state
$758.24

District of Columbia

Lowest state
$571.94

Arkansas · 33% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $654.99
CPT 43245 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $654.99, national facility $156.98.
StateRate compared visuallyNon-facilityFacility
District of Columbia
$758.24$171.59
California
$751.27$161.99
Alaska
$733.94$203.57
Washington
$730.89$163.17
New Jersey
$729.45$168.69
New York
$727.30$171.72
Hawaii
$723.17$156.94
Massachusetts
$722.44$162.92
Connecticut
$701.58$165.23
Colorado
$687.73$157.85
Oregon
$680.85$156.19
Maryland
$680.36$161.19
New Hampshire
$675.41$156.98
Rhode Island
$673.23$158.78
Florida
$670.07$170.41
Minnesota
$660.80$148.35
Puerto Rico
$660.73$157.24
Virgin Islands
$660.73$157.24
Montana
$654.96$156.96
Nevada
$653.19$154.68
Wyoming
$651.34$153.34
Illinois
$649.87$168.67
Delaware
$647.59$155.56
North Dakota
$646.66$148.65
Texas
$646.16$155.87
Pennsylvania
$645.78$157.98
South Dakota
$645.68$147.67
Vermont
$642.65$149.63
Virginia
$641.67$152.13
Arizona
$636.21$153.64
Georgia
$633.02$157.92
Michigan
$627.72$160.09
Maine
$625.69$149.84
Wisconsin
$622.57$145.48
Utah
$621.12$152.99
North Carolina
$613.70$149.06
New Mexico
$612.93$156.26
South Carolina
$611.79$151.63
Missouri
$610.25$153.24
Louisiana
$608.60$153.92
Indiana
$608.31$146.65
Ohio
$608.06$153.38
Nebraska
$604.63$144.97
Idaho
$604.34$146.17
Iowa
$600.57$144.89
Tennessee
$599.29$146.60
Kansas
$596.12$145.92
Oklahoma
$594.00$149.28
Kentucky
$593.77$151.05
West Virginia
$590.20$157.43
Alabama
$581.31$145.55
Mississippi
$576.16$147.38
Arkansas
$571.94$144.15

Billed by 1 specialties

Commercial rates for 43245

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates