# CPT 43631: Gstrct Prtl Dstl W/gastroduodenostomy

Medicare 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.

Web page: https://www.med-reveal.com/rates/43631-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: General Surgery

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $1,355.74 |
| National facility | $1,355.74 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| 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 | $1,458.18 | $1,458.18 |
| 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 | $1,369.86 | $1,369.86 |
| 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 | $1,340.09 | $1,340.09 |
| Delaware | $1,334.79 | $1,334.79 |
| Louisiana | $1,334.73 | $1,334.73 |
| 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 | $1,263.47 | $1,263.47 |
| 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 |

## 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 43631 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