# CPT 43264: Ercp Remove Calculi/debris Biliary/pancreas Duct

Medicare 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.

Web page: https://www.med-reveal.com/rates/43264-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Gastroenterology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $317.31 |
| National facility | $317.31 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $419.43 | $419.43 |
| District of Columbia | $345.47 | $345.47 |
| New York | $345.14 | $345.14 |
| Florida | $340.34 | $340.34 |
| New Jersey | $340.17 | $340.17 |
| Illinois | $337.36 | $337.36 |
| Connecticut | $332.64 | $332.64 |
| Washington | $329.88 | $329.88 |
| Massachusetts | $329.27 | $329.27 |
| 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 |

## Related codes

- 10140: I&d Hematoma Seroma/fluid Collection — https://www.med-reveal.com/rates/10140-cpt-fee-schedule
- 11055: Paring/cutting Benign Hyperkeratotic Lesion 1 — https://www.med-reveal.com/rates/11055-cpt-fee-schedule
- 11056: Paring/cutting Benign Hyperkeratotic Lesion 2-4 — https://www.med-reveal.com/rates/11056-cpt-fee-schedule
- 11057: Paring/cutting Benign Hyperkeratotic Lesion >4 — https://www.med-reveal.com/rates/11057-cpt-fee-schedule
- 11403: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 2.1-3.0 Cm — https://www.med-reveal.com/rates/11403-cpt-fee-schedule
- 11404: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 3.1-4.0 Cm — https://www.med-reveal.com/rates/11404-cpt-fee-schedule
- 11406: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l >4.0 Cm — https://www.med-reveal.com/rates/11406-cpt-fee-schedule
- 11603: Excision Mal Lesion Trunk/arm/leg 2.1-3.0 Cm — https://www.med-reveal.com/rates/11603-cpt-fee-schedule

Commercial negotiated rates for 43264 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules