CPT code 43246: PEG placement, endoscopic guidance2026 Medicare rate & RVUs in Mississippi
Reports endoscopically guided placement of a gastrostomy tube to provide stomach access for patients who cannot maintain adequate oral intake.
In Mississippi, Medicare pays $167.52 for 43246 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 43246 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 43246 covers
A physician uses an upper gastrointestinal endoscope to guide placement of a feeding tube through the abdominal wall into the stomach. This percutaneous endoscopic gastrostomy (PEG) is commonly performed for patients with dysphagia or other conditions that prevent adequate oral nutrition, including some patients with neurologic disease or head and neck cancer. The service is typically performed in a hospital or endoscopy setting by a gastroenterologist or surgeon.
Report 43246 when the endoscopic service includes placement of the gastrostomy tube; a routine diagnostic examination used to guide placement is not a separate diagnostic EGD. Document the indication, endoscopic guidance, and completed tube placement. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy family pricing applies. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeons are permitted, while team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Mississippi compares for 43246
Across 109 of 109 payment localities, the facility rate for 43246 runs from $163.46 in Arkansas to $231.27 in Alaska. Mississippi pays $167.52. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Mississippi · this page$167.52
- Los Angeles, CA · California$185.36+$17.84
- Washington, DC area · District of Columbia$194.59+$27.07
- Miami, FL · Florida$207.26+$39.74
- Chicago, IL · Illinois$202.32+$34.80
- Manhattan, NY · New York$203.40+$35.88
- Alaska · Alaska$231.27+$63.75
Other areas in Mississippi first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $165.08 |
| ArkansasArkansas | — | $163.46 |
| ArizonaArizona | — | $174.42 |
| Bakersfield, CACalifornia | — | $177.94 |
| Chico, CACalifornia | — | $176.41 |
| El Centro, CACalifornia | — | $176.50 |
| Fresno, CACalifornia | — | $176.41 |
| Hanford, CACalifornia | — | $176.41 |
| Madera, CACalifornia | — | $176.41 |
| Merced, CACalifornia | — | $176.41 |
| Modesto, CACalifornia | — | $176.41 |
| Napa, CACalifornia | — | $191.19 |
| Oxnard, CACalifornia | — | $183.08 |
| Redding, CACalifornia | — | $176.41 |
| Rest of CaliforniaCalifornia | — | $176.41 |
| Riverside, CACalifornia | — | $182.14 |
| Sacramento, CACalifornia | — | $181.61 |
| Salinas, CACalifornia | — | $180.86 |
| San Diego, CACalifornia | — | $182.50 |
| Marin County, CACalifornia | — | $198.14 |
| San Francisco, CACalifornia | — | $197.54 |
| San Benito County, CACalifornia | — | $202.68 |
| Santa Clara County, CACalifornia | — | $200.22 |
| San Luis Obispo, CACalifornia | — | $178.34 |
| Santa Cruz, CACalifornia | — | $182.20 |
| Santa Maria, CACalifornia | — | $180.82 |
| Santa Rosa, CACalifornia | — | $183.83 |
| Stockton, CACalifornia | — | $176.41 |
| Vallejo, CACalifornia | — | $190.32 |
| Visalia, CACalifornia | — | $176.41 |
| Yuba City, CACalifornia | — | $176.41 |
| ColoradoColorado | — | $178.74 |
| ConnecticutConnecticut | — | $187.84 |
| DelawareDelaware | — | $176.62 |
| Fort Lauderdale, FLFlorida | — | $193.25 |
| Rest of FloridaFlorida | — | $185.30 |
| Atlanta, GAGeorgia | — | $182.98 |
| Rest of GeorgiaGeorgia | — | $176.93 |
| Hawaii, Guam, HIHawaii | — | $177.04 |
| IowaIowa | — | $163.88 |
| IdahoIdaho | — | $165.45 |
| East St. Louis, ILIllinois | — | $192.73 |
| Rest of IllinoisIllinois | — | $184.43 |
| Suburban Chicago, ILIllinois | — | $194.05 |
| IndianaIndiana | — | $165.99 |
| KansasKansas | — | $165.28 |
| KentuckyKentucky | — | $171.89 |
| New Orleans, LALouisiana | — | $178.13 |
| Rest of LouisianaLouisiana | — | $172.47 |
| Metropolitan Boston, MAMassachusetts | — | $189.85 |
| Rest of MassachusettsMassachusetts | — | $178.99 |
| Baltimore area, MDMaryland | — | $187.68 |
| Rest of MarylandMaryland | — | $178.61 |
| Rest of MaineMaine | — | $168.09 |
| Southern Maine, MEMaine | — | $171.43 |
| Detroit, MIMichigan | — | $188.94 |
| Rest of MichiganMichigan | — | $176.75 |
| MinnesotaMinnesota | — | $167.20 |
| Metropolitan Kansas City, MOMissouri | — | $175.22 |
| Metropolitan St. Louis, MOMissouri | — | $176.25 |
| Rest of MissouriMissouri | — | $171.72 |
| MontanaMontana | — | $178.33 |
| North CarolinaNorth Carolina | — | $168.97 |
| North DakotaNorth Dakota | — | $167.85 |
| NebraskaNebraska | — | $163.90 |
| New HampshireNew Hampshire | — | $177.98 |
| Northern New JerseyNew Jersey | — | $194.03 |
| Rest of New JerseyNew Jersey | — | $188.83 |
| New MexicoNew Mexico | — | $178.20 |
| NevadaNevada | — | $175.45 |
| NYC suburbs and Long Island, NYNew York | — | $209.41 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $191.55 |
| Queens, NYNew York | — | $201.75 |
| Rest of New YorkNew York | — | $170.87 |
| OhioOhio | — | $174.61 |
| OklahomaOklahoma | — | $169.62 |
| Portland, OROregon | — | $180.65 |
| Rest of OregonOregon | — | $172.92 |
| Metropolitan Philadelphia, PAPennsylvania | — | $185.70 |
| Rest of PennsylvaniaPennsylvania | — | $173.72 |
| Puerto RicoPuerto Rico | — | $178.59 |
| Rhode IslandRhode Island | — | $180.13 |
| South CarolinaSouth Carolina | — | $172.30 |
| South DakotaSouth Dakota | — | $166.61 |
| TennesseeTennessee | — | $166.09 |
| Austin, TXTexas | — | $179.17 |
| Beaumont, TXTexas | — | $173.08 |
| Brazoria, TXTexas | — | $174.99 |
| Dallas, TXTexas | — | $176.71 |
| Fort Worth, TXTexas | — | $176.49 |
| Galveston, TXTexas | — | $175.93 |
| Houston, TXTexas | — | $185.63 |
| Rest of TexasTexas | — | $174.36 |
| UtahUtah | — | $173.87 |
| VirginiaVirginia | — | $172.40 |
| Virgin Islands, VIUnited States Virgin Islands | — | $178.59 |
| VermontVermont | — | $169.17 |
| Rest of WashingtonWashington | — | $178.01 |
| King County, WAWashington | — | $191.08 |
| WisconsinWisconsin | — | $164.23 |
| West VirginiaWest Virginia | — | $180.13 |
| WyomingWyoming | — | $173.76 |
43246 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 43246 rate is calculated
Each of 43246’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 43246
RVUs × geographic indexes × conversion factor
Work3.47
3.47 RVUs× 1.000 GPCI
Practice expense1.34
1.34 RVUs× 1.000 GPCI
Malpractice0.53
0.53 RVUs× 1.000 GPCI
Adjusted RVUs
5.3400
Conversion factor
$33.4009
Medicare rate
$178.36
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Mississippi inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,174
- Code
- 43246
- Physician work
- 3.47
- Practice expense
- 1.34
- Malpractice
- 0.53
GPCI2026.csv
67
- Locality
- Mississippi
- Physician work
- 1.000
- Practice expense
- 0.861
- Malpractice
- 0.739
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.47 | × 1.000 | 3.4700 |
| Practice expense | 1.34 | × 0.861 | 1.1537 |
| Malpractice | 0.53 | × 0.739 | 0.3917 |
| Total RVUs | 5.0154 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Mississippi$167.52
Facility: (3.47 × 1 + 1.34 × 0.861 + 0.53 × 0.739) × $33.4009 = $167.52
Payment rules and modifiers for 43246
The CMS indicators that decide how 43246 is paid alongside other services.
CMS payment indicators · 43246
PEG placement, endoscopic guidance
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
43246 without 51 · national facility
$178.36
PEG placement, endoscopic guidance
43246-51 · Second procedure: 50%
$89.18
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 43246 has changed in Mississippi
43246 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $167.52 | RVU26D |
| 2026-07-01 | Not available in this setting | $167.52 | RVU26C |
| 2026-04-01 | Not available in this setting | $167.52 | RVU26B |
| 2026-01-01 | Not available in this setting | $167.52 | RVU26A |
| 2025-10-01 | Not available in this setting | $179.25 | RVU25D |
| 2025-07-01 | Not available in this setting | $179.25 | RVU25C |
| 2025-04-01 | Not available in this setting | $179.25 | RVU25B |
| 2025-01-01 | Not available in this setting | $179.25 | RVU25A |
| 2024-10-01 | Not available in this setting | $183.90 | RVU24D |
| 2024-07-01 | Not available in this setting | $183.90 | RVU24C |
| 2024-04-01 | Not available in this setting | $183.90 | RVU24B |
| 2024-03-09 | Not available in this setting | $183.90 | RVU24AR |
| 2024-01-01 | Not available in this setting | $180.90 | RVU24A |
| 2023-10-01 | Not available in this setting | $185.19 | RVU23D |
| 2023-07-01 | Not available in this setting | $185.19 | RVU23C |
| 2023-04-01 | Not available in this setting | $185.19 | RVU23B |
| 2023-01-01 | Not available in this setting | $185.19 | RVU23A |
| 2022-10-01 | Not available in this setting | $187.43 | RVU22D |
| 2022-07-01 | Not available in this setting | $187.43 | RVU22C |
| 2022-04-01 | Not available in this setting | $187.43 | RVU22B |
| 2022-01-01 | Not available in this setting | $187.43 | RVU22A |
| 2021-10-01 | Not available in this setting | $187.99 | RVU21D |
| 2021-07-01 | Not available in this setting | $187.99 | RVU21C |
| 2021-04-01 | Not available in this setting | $187.99 | RVU21B |
| 2021-01-01 | Not available in this setting | $187.99 | RVU21A |
| 2020-10-01 | Not available in this setting | $191.51 | RVU20D |
| 2020-07-01 | Not available in this setting | $191.51 | RVU20C |
| 2020-04-01 | Not available in this setting | $191.51 | RVU20B |
| 2020-01-01 | Not available in this setting | $191.51 | RVU20A |
| 2019-10-01 | Not available in this setting | $190.50 | RVU19D |
| 2019-07-01 | Not available in this setting | $190.50 | RVU19C |
| 2019-04-01 | Not available in this setting | $190.50 | RVU19B |
| 2019-01-01 | Not available in this setting | $190.50 | RVU19A |
| 2018-10-01 | Not available in this setting | $190.92 | RVU18D |
| 2018-07-01 | Not available in this setting | $190.92 | RVU18C |
| 2018-04-01 | Not available in this setting | $190.92 | RVU18B |
| 2018-01-01 | Not available in this setting | $190.92 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $192.55 | RVU17D |
| 2017-07-01 | Not available in this setting | $192.55 | RVU17C |
| 2017-04-01 | Not available in this setting | $192.55 | RVU17B |
| 2017-01-01 | Not available in this setting | $192.55 | RVU17A |
| 2016-10-01 | Not available in this setting | $199.33 | RVU16D |
| 2016-07-01 | Not available in this setting | $199.33 | RVU16C |
| 2016-04-01 | Not available in this setting | $199.33 | RVU16B |
| 2016-01-01 | Not available in this setting | $199.33 | RVU16A |
| 2015-10-01 | Not available in this setting | $202.26 | RVU15D |
| 2015-07-01 | Not available in this setting | $202.26 | RVU15C |
| 2015-04-01 | Not available in this setting | $201.25 | RVU15B |
| 2015-01-01 | Not available in this setting | $201.25 | RVU15A |
| 2014-10-01 | Not available in this setting | $204.81 | RVU14D |
| 2014-07-01 | Not available in this setting | $204.81 | RVU14C |
| 2014-04-01 | Not available in this setting | $204.81 | RVU14B |
| 2014-01-01 | Not available in this setting | $204.81 | RVU14A |
| 2013-10-01 | Not available in this setting | $238.21 | RVU13D |
| 2013-07-01 | Not available in this setting | $238.21 | RVU13C |
| 2013-04-01 | Not available in this setting | $238.21 | RVU13B |
| 2013-01-01 | Not available in this setting | $238.21 | RVU13AR |
Where the Mississippi rate applies
Mississippi is a Medicare payment area, not a city. Our Census mapping connects it to 427 cities and communities in Mississippi. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Aberdeen
- Ackerman
- Agricola
- Alcorn State University
- Algoma
- Alligator
- Amory
43246 billing questions
How is 43246 different from 43241?
43246 is for placing a gastrostomy tube through the abdominal wall into the stomach under endoscopic guidance. 43241 describes endoscopic insertion of an intraluminal tube or catheter, such as a tube placed through the natural passage.
Can a diagnostic EGD be reported separately with 43246?
Do not separately report a diagnostic EGD solely for the examination used to guide gastrostomy tube placement. The endoscopic guidance is part of the placement service.
What documentation supports 43246?
Document the clinical need for gastrostomy access, the endoscopic guidance, and that the tube was placed. The record should identify the provider or providers who performed the service.
Does modifier 50 apply if the procedure involves both sides?
No. CMS identifies bilateral adjustment as inappropriate for 43246; modifier 50 is not appropriate for this service.
When is assistant-at-surgery payment allowed?
CMS allows assistant-at-surgery payment only when medical necessity is documented. Co-surgeons are permitted, but team surgery is not.
How does CMS price 43246 with another endoscopy?
When related endoscopies are performed together, CMS applies endoscopy family pricing. The code has a 0-day global period, which includes same-day preoperative and postoperative care.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets · Coming soon
Put 43246 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist