# CPT 43634: Gstrct Prtl Dstl W/frmj Intstinal Pouch

Medicare CPT 43634 pays $1,961.97 in a non-facility setting and $1,961.97 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $1,721.91 in Wisconsin to $2,444.19 in Alaska, a 42% spread.

Web page: https://www.med-reveal.com/rates/43634-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: General Surgery

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $1,961.97 |
| National facility | $1,961.97 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $2,444.19 | $2,444.19 |
| Florida | $2,266.06 | $2,266.06 |
| Illinois | $2,242.18 | $2,242.18 |
| New York | $2,185.40 | $2,185.40 |
| District of Columbia | $2,142.48 | $2,142.48 |
| New Jersey | $2,106.39 | $2,106.39 |
| Connecticut | $2,087.55 | $2,087.55 |
| Michigan | $2,064.82 | $2,064.82 |
| West Virginia | $2,040.89 | $2,040.89 |
| Maryland | $2,021.35 | $2,021.35 |
| Georgia | $2,005.90 | $2,005.90 |
| Massachusetts | $2,001.43 | $2,001.43 |
| Washington | $1,995.00 | $1,995.00 |
| New Mexico | $1,988.93 | $1,988.93 |
| Pennsylvania | $1,985.55 | $1,985.55 |
| Rhode Island | $1,964.94 | $1,964.94 |
| Puerto Rico | $1,962.12 | $1,962.12 |
| Virgin Islands | $1,962.12 | $1,962.12 |
| Montana | $1,961.33 | $1,961.33 |
| California | $1,940.76 | $1,940.76 |
| New Hampshire | $1,940.43 | $1,940.43 |
| Texas | $1,938.83 | $1,938.83 |
| Louisiana | $1,937.91 | $1,937.91 |
| Colorado | $1,935.03 | $1,935.03 |
| Delaware | $1,930.26 | $1,930.26 |
| Ohio | $1,925.44 | $1,925.44 |
| Missouri | $1,919.97 | $1,919.97 |
| Nevada | $1,909.04 | $1,909.04 |
| Oregon | $1,907.17 | $1,907.17 |
| Utah | $1,902.41 | $1,902.41 |
| Arizona | $1,902.01 | $1,902.01 |
| Hawaii | $1,888.94 | $1,888.94 |
| Kentucky | $1,884.93 | $1,884.93 |
| South Carolina | $1,879.88 | $1,879.88 |
| Wyoming | $1,878.86 | $1,878.86 |
| Virginia | $1,860.36 | $1,860.36 |
| Oklahoma | $1,842.62 | $1,842.62 |
| Maine | $1,822.59 | $1,822.59 |
| North Carolina | $1,816.48 | $1,816.48 |
| Mississippi | $1,816.10 | $1,816.10 |
| Vermont | $1,799.57 | $1,799.57 |
| Tennessee | $1,773.09 | $1,773.09 |
| North Dakota | $1,772.10 | $1,772.10 |
| Alabama | $1,767.09 | $1,767.09 |
| Indiana | $1,764.88 | $1,764.88 |
| Kansas | $1,760.30 | $1,760.30 |
| Idaho | $1,757.58 | $1,757.58 |
| Minnesota | $1,749.97 | $1,749.97 |
| South Dakota | $1,749.72 | $1,749.72 |
| Arkansas | $1,743.60 | $1,743.60 |
| Iowa | $1,731.04 | $1,731.04 |
| Nebraska | $1,728.56 | $1,728.56 |
| Wisconsin | $1,721.91 | $1,721.91 |

## 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 43634 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