CPT 43261

Ercp W/Biopsy Single/Multiple

CPT 43261 pays $295.60 in a non-facility setting and $295.60 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $274.48 in Arkansas to $390.49 in Alaska, a 42% spread.

National non-facility rate

$295.60

Office and other outpatient settings

Facility rate
$295.60

Hospital and ASC settings

Highest state
$390.49

Alaska

Lowest state
$274.48

Arkansas · 42% 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 $295.60
CPT 43261 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $295.60, national facility $295.60.
StateRate compared visuallyNon-facilityFacility
Alaska
$390.49$390.49
District of Columbia
$321.91$321.91
New York
$321.56$321.56
Florida
$317.03$317.03
New Jersey
$316.94$316.94
Illinois
$314.23$314.23
Connecticut
$309.91$309.91
Washington
$307.38$307.38
Massachusetts
$306.80$306.80
California
$305.88$305.88
Maryland
$303.03$303.03
Michigan
$300.28$300.28
Rhode Island
$299.39$299.39
Colorado
$297.76$297.76
Pennsylvania
$297.45$297.45
Georgia
$296.95$296.95
Hawaii
$296.15$296.15
Puerto Rico
$296.06$296.06
Virgin Islands
$296.06$296.06
New Hampshire
$295.79$295.79
West Virginia
$295.70$295.70
Montana
$295.55$295.55
Oregon
$294.91$294.91
New Mexico
$294.05$294.05
Texas
$293.98$293.98
Delaware
$293.47$293.47
Nevada
$291.93$291.93
Louisiana
$290.31$290.31
Arizona
$290.12$290.12
Wyoming
$289.78$289.78
Ohio
$289.44$289.44
Missouri
$289.25$289.25
Utah
$288.95$288.95
Virginia
$287.78$287.78
South Carolina
$286.71$286.71
Kentucky
$285.61$285.61
Maine
$284.00$284.00
Vermont
$283.81$283.81
Oklahoma
$282.82$282.82
North Carolina
$282.64$282.64
North Dakota
$282.31$282.31
Minnesota
$281.96$281.96
South Dakota
$280.74$280.74
Mississippi
$279.64$279.64
Indiana
$278.78$278.78
Tennessee
$278.61$278.61
Idaho
$277.98$277.98
Kansas
$277.51$277.51
Wisconsin
$277.05$277.05
Alabama
$276.78$276.78
Nebraska
$276.07$276.07
Iowa
$275.91$275.91
Arkansas
$274.48$274.48

Billed by 1 specialties

Commercial rates for 43261

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

See negotiated rates