CPT 43248

Egd Insert Guide Wire Dilator Passage Esophagus

CPT 43248 pays $457.93 in a non-facility setting and $147.97 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $402.83 in Arkansas to $526.94 in District of Columbia, a 31% spread.

National non-facility rate

$457.93

Office and other outpatient settings

Facility rate
$147.97

Hospital and ASC settings

Highest state
$526.94

District of Columbia

Lowest state
$402.83

Arkansas · 31% 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 $457.93
CPT 43248 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $457.93, national facility $147.97.
StateRate compared visuallyNon-facilityFacility
District of Columbia
$526.94$161.80
Alaska
$523.12$193.01
California
$520.59$153.82
New Jersey
$508.06$159.05
Washington
$507.76$154.40
New York
$507.16$161.37
Massachusetts
$502.29$154.05
Hawaii
$501.33$148.90
Connecticut
$489.29$155.46
Colorado
$479.09$149.29
Maryland
$474.99$151.85
Oregon
$474.36$147.82
New Hampshire
$470.93$148.26
Rhode Island
$470.11$149.92
Florida
$469.85$158.86
Puerto Rico
$461.62$148.25
Virgin Islands
$461.62$148.25
Minnesota
$460.13$141.18
Montana
$457.90$147.94
Illinois
$456.73$157.23
Nevada
$456.38$146.11
Wyoming
$454.97$145.01
Delaware
$453.03$146.79
Pennsylvania
$452.35$148.75
Texas
$452.19$147.03
North Dakota
$451.18$141.22
South Dakota
$450.39$140.43
Vermont
$448.80$141.94
Virginia
$448.61$143.92
Arizona
$445.39$145.04
Georgia
$444.12$148.42
Michigan
$441.10$150.05
Maine
$438.03$141.87
Utah
$435.67$144.30
Wisconsin
$435.30$138.35
New Mexico
$431.02$146.78
North Carolina
$430.26$141.07
South Carolina
$429.49$143.09
Missouri
$428.79$144.35
Louisiana
$427.86$144.87
Ohio
$427.42$144.42
Indiana
$426.41$139.08
Idaho
$423.80$138.64
Nebraska
$423.78$137.69
Iowa
$421.18$137.57
Tennessee
$420.66$138.91
Kansas
$418.53$138.33
Kentucky
$417.92$142.37
Oklahoma
$417.76$140.97
West Virginia
$416.75$147.39
Alabama
$409.03$137.82
Mississippi
$406.07$139.20
Arkansas
$402.83$136.57

Billed by 1 specialties

Commercial rates for 43248

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

See negotiated rates