CPT 43631

Gstrct Prtl Dstl W/Gastroduodenostomy

CPT 43631 pays $1,355.74 in a non-facility setting and $1,355.74 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $1,199.03 in Wisconsin to $1,685.71 in Alaska, a 41% spread.

National non-facility rate

$1,355.74

Office and other outpatient settings

Facility rate
$1,355.74

Hospital and ASC settings

Highest state
$1,685.71

Alaska

Lowest state
$1,199.03

Wisconsin · 41% 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 $1,355.74
CPT 43631 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $1,355.74, national facility $1,355.74.
StateRate compared visuallyNon-facilityFacility
Alaska
$1,685.71$1,685.71
Florida
$1,551.06$1,551.06
Illinois
$1,533.47$1,533.47
New York
$1,508.06$1,508.06
District of Columbia
$1,484.75$1,484.75
New Jersey
$1,458.17$1,458.17
Connecticut
$1,441.91$1,441.91
Michigan
$1,417.82$1,417.82
West Virginia
$1,397.97$1,397.97
Maryland
$1,396.99$1,396.99
Massachusetts
$1,389.92$1,389.92
Washington
$1,386.95$1,386.95
Georgia
$1,381.03$1,381.03
Pennsylvania
$1,369.85$1,369.85
New Mexico
$1,367.72$1,367.72
Rhode Island
$1,360.39$1,360.39
Puerto Rico
$1,356.54$1,356.54
Virgin Islands
$1,356.54$1,356.54
Montana
$1,355.33$1,355.33
California
$1,355.07$1,355.07
New Hampshire
$1,344.55$1,344.55
Colorado
$1,342.96$1,342.96
Texas
$1,340.08$1,340.08
Delaware
$1,334.79$1,334.79
Louisiana
$1,334.72$1,334.72
Ohio
$1,326.73$1,326.73
Oregon
$1,324.28$1,324.28
Missouri
$1,323.52$1,323.52
Nevada
$1,321.85$1,321.85
Hawaii
$1,317.68$1,317.68
Arizona
$1,315.29$1,315.29
Utah
$1,313.68$1,313.68
Wyoming
$1,302.42$1,302.42
Kentucky
$1,299.20$1,299.20
South Carolina
$1,298.20$1,298.20
Virginia
$1,289.46$1,289.46
Oklahoma
$1,272.30$1,272.30
Maine
$1,263.46$1,263.46
North Carolina
$1,258.10$1,258.10
Mississippi
$1,253.24$1,253.24
Vermont
$1,250.91$1,250.91
North Dakota
$1,233.92$1,233.92
Tennessee
$1,228.72$1,228.72
Indiana
$1,224.61$1,224.61
Alabama
$1,222.69$1,222.69
Minnesota
$1,221.58$1,221.58
Kansas
$1,220.19$1,220.19
South Dakota
$1,219.57$1,219.57
Idaho
$1,219.47$1,219.47
Arkansas
$1,206.59$1,206.59
Iowa
$1,202.13$1,202.13
Nebraska
$1,201.05$1,201.05
Wisconsin
$1,199.03$1,199.03

Billed by 1 specialties

Commercial rates for 43631

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

See negotiated rates