CPT 43264

Ercp Remove Calculi/Debris Biliary/Pancreas Duct

CPT 43264 pays $317.31 in a non-facility setting and $317.31 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $294.72 in Arkansas to $419.43 in Alaska, a 42% spread.

National non-facility rate

$317.31

Office and other outpatient settings

Facility rate
$317.31

Hospital and ASC settings

Highest state
$419.43

Alaska

Lowest state
$294.72

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 $317.31
CPT 43264 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $317.31, national facility $317.31.
StateRate compared visuallyNon-facilityFacility
Alaska
$419.43$419.43
District of Columbia
$345.47$345.47
New York
$345.14$345.14
Florida
$340.33$340.33
New Jersey
$340.17$340.17
Illinois
$337.36$337.36
Connecticut
$332.64$332.64
Washington
$329.88$329.88
Massachusetts
$329.26$329.26
California
$328.24$328.24
Maryland
$325.27$325.27
Michigan
$322.38$322.38
Rhode Island
$321.37$321.37
Colorado
$319.59$319.59
Pennsylvania
$319.32$319.32
Georgia
$318.79$318.79
Hawaii
$317.80$317.80
Puerto Rico
$317.80$317.80
Virgin Islands
$317.80$317.80
West Virginia
$317.52$317.52
New Hampshire
$317.48$317.48
Montana
$317.26$317.26
Oregon
$316.53$316.53
New Mexico
$315.71$315.71
Texas
$315.58$315.58
Delaware
$315.03$315.03
Nevada
$313.37$313.37
Louisiana
$311.70$311.70
Arizona
$311.44$311.44
Wyoming
$311.06$311.06
Ohio
$310.76$310.76
Missouri
$310.55$310.55
Utah
$310.21$310.21
Virginia
$308.92$308.92
South Carolina
$307.81$307.81
Kentucky
$306.66$306.66
Maine
$304.88$304.88
Vermont
$304.65$304.65
Oklahoma
$303.65$303.65
North Carolina
$303.44$303.44
North Dakota
$303.02$303.02
Minnesota
$302.63$302.63
South Dakota
$301.34$301.34
Mississippi
$300.26$300.26
Indiana
$299.29$299.29
Tennessee
$299.12$299.12
Idaho
$298.44$298.44
Kansas
$297.94$297.94
Wisconsin
$297.41$297.41
Alabama
$297.19$297.19
Nebraska
$296.38$296.38
Iowa
$296.22$296.22
Arkansas
$294.72$294.72

Billed by 1 specialties

Commercial rates for 43264

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

See negotiated rates