CPT code 43264: ERCP extraction, duct stones or debris2026 Medicare rate & RVUs in Arkansas

In Arkansas, Medicare pays $294.72 for 43264 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 43264 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 43264 covers

During ERCP, a gastroenterologist or other qualified endoscopist passes a side-viewing endoscope through the mouth to the duodenum, accesses the biliary or pancreatic duct, and retrieves calculi or debris, commonly with a balloon or basket. Typical cases include removing common bile duct stones in a patient with choledocholithiasis or clearing ductal debris. The service is performed in settings such as a hospital or ambulatory surgery center.

Report this code when the documented work includes ductal stone or debris extraction; use the distinct lithotripsy service when calculi are fragmented. The record should identify the treated duct and describe the retrieval performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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 Arkansas compares for 43264

Across 109 of 109 payment localities, the facility rate for 43264 runs from $294.72 in Arkansas to $419.43 in Alaska. Arkansas pays $294.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

43264 rates by state

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

See 43264 in every payment locality

How the 43264 rate is calculated

Each of 43264’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 43264

The CMS indicators that decide how 43264 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 43264

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

How 43264 has changed in Arkansas

Price 43264 for an earlier date of service

Where the Arkansas rate applies

Arkansas is a Medicare payment area, not a city. Our Census mapping connects it to 626 cities and communities in Arkansas. Some span more than one payment area; confirm with the service ZIP.

• Acorn
• Adona
• Alexander
• Alicia
• Alix
• Alleene
• Allport
• Alma

Browse all communities in Arkansas

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