CPT 43274

Ercp Stent Placement Biliary/Pancreatic Duct

CPT 43274 pays $402.15 in a non-facility setting and $402.15 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $373.82 in Arkansas to $532.65 in Alaska, a 42% spread.

National non-facility rate

$402.15

Office and other outpatient settings

Facility rate
$402.15

Hospital and ASC settings

Highest state
$532.65

Alaska

Lowest state
$373.82

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 $402.15
CPT 43274 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $402.15, national facility $402.15.
StateRate compared visuallyNon-facilityFacility
Alaska
$532.65$532.65
District of Columbia
$437.48$437.48
New York
$437.29$437.29
Florida
$431.55$431.55
New Jersey
$430.90$430.90
Illinois
$427.89$427.89
Connecticut
$421.45$421.45
Washington
$417.69$417.69
Massachusetts
$416.97$416.97
California
$415.43$415.43
Maryland
$412.16$412.16
Michigan
$408.86$408.86
Rhode Island
$407.22$407.22
Colorado
$404.82$404.82
Pennsylvania
$404.80$404.80
Georgia
$404.22$404.22
West Virginia
$402.92$402.92
Puerto Rico
$402.73$402.73
Virgin Islands
$402.73$402.73
Hawaii
$402.25$402.25
New Hampshire
$402.21$402.21
Montana
$402.09$402.09
Oregon
$400.95$400.95
New Mexico
$400.42$400.42
Texas
$400.01$400.01
Delaware
$399.28$399.28
Nevada
$397.11$397.11
Louisiana
$395.31$395.31
Arizona
$394.77$394.77
Wyoming
$394.16$394.16
Ohio
$394.11$394.11
Missouri
$393.83$393.83
Utah
$393.30$393.30
Virginia
$391.49$391.49
South Carolina
$390.30$390.30
Kentucky
$388.97$388.97
Maine
$386.43$386.43
Vermont
$386.01$386.01
Oklahoma
$385.11$385.11
North Carolina
$384.68$384.68
North Dakota
$383.89$383.89
Minnesota
$383.27$383.27
South Dakota
$381.74$381.74
Mississippi
$380.89$380.89
Indiana
$379.40$379.40
Tennessee
$379.26$379.26
Idaho
$378.34$378.34
Kansas
$377.77$377.77
Alabama
$376.91$376.91
Wisconsin
$376.88$376.88
Nebraska
$375.70$375.70
Iowa
$375.53$375.53
Arkansas
$373.82$373.82

Billed by 1 specialties

Commercial rates for 43274

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

See negotiated rates