CPT code 43260: ERCP, brushing or washing2026 Medicare rate & RVUs in New Mexico

In New Mexico, Medicare pays $279.27 for 43260 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 43260 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 43260 covers

A gastroenterologist advances an endoscope through the mouth to the duodenum, accesses the biliary or pancreatic ducts, and uses contrast imaging to evaluate ductal anatomy. This service includes collecting duct specimens by brushing or washing when performed. It may be used to investigate a suspected ductal stricture, obstruction, or other abnormality, often in a hospital or ambulatory endoscopy facility.

Report 43260 when the documented ERCP includes brushing or washing for specimen collection; forceps tissue sampling is distinguished by 43261. Documentation should identify the duct examined, the collection method, and the findings. The 0-day global period includes same-day preoperative and postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are 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 New Mexico compares for 43260

Across 109 of 109 payment localities, the facility rate for 43260 runs from $261.02 in Arkansas to $371.33 in Alaska. New Mexico pays $279.27. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

43260 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 43260 in every payment locality

How the 43260 rate is calculated

Each of 43260’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.

Payment rules and modifiers for 43260

The CMS indicators that decide how 43260 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 43260

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 43260 has changed in New Mexico

Price 43260 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

• Abeytas
• Abiquiu
• Acomita Lake
• Adelino
• Agua Fria
• Alamillo
• Alamo
• Alamogordo

Browse all communities in New Mexico

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

Open CMS sourceHow we calculate rates