CPT code 43266: Endoscopic stent, upper GI tract2026 Medicare rate & RVUs in New Mexico
Report upper GI endoscopic stent placement when an endoscopist deploys a stent to maintain luminal patency or seal a leak during transoral EGD.
In New Mexico, Medicare pays $191.56 for 43266 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 43266 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 43266 covers
During flexible transoral EGD, the endoscopist advances and deploys a stent to maintain patency or seal a leak in the upper gastrointestinal tract. Typical cases include palliation of an obstructing esophageal tumor and endoscopic treatment of a selected luminal narrowing or leak. Gastroenterologists and therapeutic endoscopists perform this service in a hospital or ambulatory endoscopy facility.
Report 43266 for stent deployment; the service includes guidewire passage and pre- or post-dilation when performed. The record should identify the target, indication, stent placement, and any dilation performed. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy-family pricing applies. Modifier 50 is inappropriate; Medicare does not pay an assistant at surgery, and 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 43266
Across 109 of 109 payment localities, the facility rate for 43266 runs from $177.74 in Arkansas to $252.16 in Alaska. New Mexico pays $191.56. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$191.56
- Los Angeles, CA · California$201.16+$9.60
- Washington, DC area · District of Columbia$209.77+$18.21
- Miami, FL · Florida$218.90+$27.34
- Chicago, IL · Illinois$214.29+$22.73
- Manhattan, NY · New York$217.85+$26.29
- Alaska · Alaska$252.16+$60.60
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $179.34 |
| ArkansasArkansas | — | $177.74 |
| ArizonaArizona | — | $188.57 |
| Bakersfield, CACalifornia | — | $193.23 |
| Chico, CACalifornia | — | $191.80 |
| El Centro, CACalifornia | — | $191.88 |
| Fresno, CACalifornia | — | $191.80 |
| Hanford, CACalifornia | — | $191.80 |
| Madera, CACalifornia | — | $191.80 |
| Merced, CACalifornia | — | $191.80 |
| Modesto, CACalifornia | — | $191.80 |
| Napa, CACalifornia | — | $208.05 |
| Oxnard, CACalifornia | — | $198.79 |
| Redding, CACalifornia | — | $191.80 |
| Rest of CaliforniaCalifornia | — | $191.80 |
| Riverside, CACalifornia | — | $197.01 |
| Sacramento, CACalifornia | — | $197.49 |
| Salinas, CACalifornia | — | $196.66 |
| San Diego, CACalifornia | — | $198.43 |
| Marin County, CACalifornia | — | $215.83 |
| San Francisco, CACalifornia | — | $215.29 |
| San Benito County, CACalifornia | — | $220.54 |
| Santa Clara County, CACalifornia | — | $218.31 |
| San Luis Obispo, CACalifornia | — | $193.90 |
| Santa Cruz, CACalifornia | — | $198.11 |
| Santa Maria, CACalifornia | — | $196.62 |
| Santa Rosa, CACalifornia | — | $199.90 |
| Stockton, CACalifornia | — | $191.80 |
| Vallejo, CACalifornia | — | $207.26 |
| Visalia, CACalifornia | — | $191.80 |
| Yuba City, CACalifornia | — | $191.80 |
| ColoradoColorado | — | $193.53 |
| ConnecticutConnecticut | — | $202.06 |
| DelawareDelaware | — | $190.82 |
| Fort Lauderdale, FLFlorida | — | $205.98 |
| Rest of FloridaFlorida | — | $198.31 |
| Atlanta, GAGeorgia | — | $196.77 |
| Rest of GeorgiaGeorgia | — | $190.20 |
| Hawaii, Guam, HIHawaii | — | $192.32 |
| IowaIowa | — | $178.58 |
| IdahoIdaho | — | $180.04 |
| East St. Louis, ILIllinois | — | $204.74 |
| Rest of IllinoisIllinois | — | $197.17 |
| Suburban Chicago, ILIllinois | — | $206.98 |
| IndianaIndiana | — | $180.59 |
| KansasKansas | — | $179.76 |
| KentuckyKentucky | — | $185.61 |
| New Orleans, LALouisiana | — | $191.69 |
| Rest of LouisianaLouisiana | — | $186.11 |
| Metropolitan Boston, MAMassachusetts | — | $205.32 |
| Rest of MassachusettsMassachusetts | — | $193.76 |
| Baltimore area, MDMaryland | — | $201.79 |
| Rest of MarylandMaryland | — | $192.94 |
| Rest of MaineMaine | — | $182.43 |
| Southern Maine, MEMaine | — | $186.03 |
| Detroit, MIMichigan | — | $201.68 |
| Rest of MichiganMichigan | — | $190.21 |
| MinnesotaMinnesota | — | $182.52 |
| Metropolitan Kansas City, MOMissouri | — | $189.05 |
| Metropolitan St. Louis, MOMissouri | — | $190.08 |
| Rest of MissouriMissouri | — | $185.24 |
| MississippiMississippi | — | $181.43 |
| MontanaMontana | — | $192.36 |
| North CarolinaNorth Carolina | — | $183.33 |
| North DakotaNorth Dakota | — | $182.87 |
| NebraskaNebraska | — | $178.66 |
| New HampshireNew Hampshire | — | $192.38 |
| Northern New JerseyNew Jersey | — | $209.32 |
| Rest of New JerseyNew Jersey | — | $203.53 |
| NevadaNevada | — | $189.76 |
| NYC suburbs and Long Island, NYNew York | — | $223.51 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $206.13 |
| Queens, NYNew York | — | $216.52 |
| Rest of New YorkNew York | — | $185.19 |
| OhioOhio | — | $188.27 |
| OklahomaOklahoma | — | $183.60 |
| Portland, OROregon | — | $195.74 |
| Rest of OregonOregon | — | $187.43 |
| Metropolitan Philadelphia, PAPennsylvania | — | $199.78 |
| Rest of PennsylvaniaPennsylvania | — | $187.51 |
| Puerto RicoPuerto Rico | — | $192.69 |
| Rhode IslandRhode Island | — | $194.69 |
| South CarolinaSouth Carolina | — | $186.28 |
| South DakotaSouth Dakota | — | $181.74 |
| TennesseeTennessee | — | $180.53 |
| Austin, TXTexas | — | $193.65 |
| Beaumont, TXTexas | — | $186.86 |
| Brazoria, TXTexas | — | $189.44 |
| Dallas, TXTexas | — | $191.07 |
| Fort Worth, TXTexas | — | $190.79 |
| Galveston, TXTexas | — | $190.31 |
| Houston, TXTexas | — | $199.10 |
| Rest of TexasTexas | — | $188.35 |
| UtahUtah | — | $187.83 |
| VirginiaVirginia | — | $186.85 |
| Virgin Islands, VIUnited States Virgin Islands | — | $192.69 |
| VermontVermont | — | $183.98 |
| Rest of WashingtonWashington | — | $192.80 |
| King County, WAWashington | — | $206.90 |
| WisconsinWisconsin | — | $179.25 |
| West VirginiaWest Virginia | — | $192.91 |
| WyomingWyoming | — | $188.22 |
43266 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 43266 rate is calculated
Each of 43266’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 · 43266
RVUs × geographic indexes × conversion factor
Work3.82
3.82 RVUs× 1.000 GPCI
Practice expense1.46
1.46 RVUs× 1.000 GPCI
Malpractice0.48
0.48 RVUs× 1.000 GPCI
Adjusted RVUs
5.7600
Conversion factor
$33.4009
Medicare rate
$192.39
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,194
- Code
- 43266
- Physician work
- 3.82
- Practice expense
- 1.46
- Malpractice
- 0.48
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.82 | × 1.000 | 3.8200 |
| Practice expense | 1.46 | × 0.917 | 1.3388 |
| Malpractice | 0.48 | × 1.201 | 0.5765 |
| Total RVUs | 5.7353 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$191.56
Facility: (3.82 × 1 + 1.46 × 0.917 + 0.48 × 1.201) × $33.4009 = $191.56
Payment rules and modifiers for 43266
The CMS indicators that decide how 43266 is paid alongside other services.
CMS payment indicators · 43266
Endoscopic stent, upper GI tract
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not 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
43266 without 51 · national facility
$192.39
Endoscopic stent, upper GI tract
43266-51 · Second procedure: 50%
$96.20
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 43266 has changed in New Mexico
43266 · 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
January 1, 2014
RVU14A
No ratechanged toNo rate
Held through RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $191.56 | RVU26D |
| 2026-07-01 | Not available in this setting | $191.56 | RVU26C |
| 2026-04-01 | Not available in this setting | $191.56 | RVU26B |
| 2026-01-01 | Not available in this setting | $191.56 | RVU26A |
| 2025-10-01 | Not available in this setting | $205.25 | RVU25D |
| 2025-07-01 | Not available in this setting | $205.25 | RVU25C |
| 2025-04-01 | Not available in this setting | $205.25 | RVU25B |
| 2025-01-01 | Not available in this setting | $205.25 | RVU25A |
| 2024-10-01 | Not available in this setting | $210.62 | RVU24D |
| 2024-07-01 | Not available in this setting | $210.62 | RVU24C |
| 2024-04-01 | Not available in this setting | $210.62 | RVU24B |
| 2024-03-09 | Not available in this setting | $210.62 | RVU24AR |
| 2024-01-01 | Not available in this setting | $207.18 | RVU24A |
| 2023-10-01 | Not available in this setting | $212.65 | RVU23D |
| 2023-07-01 | Not available in this setting | $212.65 | RVU23C |
| 2023-04-01 | Not available in this setting | $212.65 | RVU23B |
| 2023-01-01 | Not available in this setting | $212.65 | RVU23A |
| 2022-10-01 | Not available in this setting | $216.61 | RVU22D |
| 2022-07-01 | Not available in this setting | $216.61 | RVU22C |
| 2022-04-01 | Not available in this setting | $216.61 | RVU22B |
| 2022-01-01 | Not available in this setting | $216.61 | RVU22A |
| 2021-10-01 | Not available in this setting | $216.65 | RVU21D |
| 2021-07-01 | Not available in this setting | $216.65 | RVU21C |
| 2021-04-01 | Not available in this setting | $216.65 | RVU21B |
| 2021-01-01 | Not available in this setting | $216.65 | RVU21A |
| 2020-10-01 | Not available in this setting | $224.31 | RVU20D |
| 2020-07-01 | Not available in this setting | $224.31 | RVU20C |
| 2020-04-01 | Not available in this setting | $224.31 | RVU20B |
| 2020-01-01 | Not available in this setting | $224.31 | RVU20A |
| 2019-10-01 | Not available in this setting | $229.84 | RVU19D |
| 2019-07-01 | Not available in this setting | $229.84 | RVU19C |
| 2019-04-01 | Not available in this setting | $229.84 | RVU19B |
| 2019-01-01 | Not available in this setting | $229.84 | RVU19A |
| 2018-10-01 | Not available in this setting | $230.13 | RVU18D |
| 2018-07-01 | Not available in this setting | $230.13 | RVU18C |
| 2018-04-01 | Not available in this setting | $230.13 | RVU18B |
| 2018-01-01 | Not available in this setting | $230.13 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $228.94 | RVU17D |
| 2017-07-01 | Not available in this setting | $228.94 | RVU17C |
| 2017-04-01 | Not available in this setting | $228.94 | RVU17B |
| 2017-01-01 | Not available in this setting | $228.94 | RVU17A |
| 2016-10-01 | Not available in this setting | $240.95 | RVU16D |
| 2016-07-01 | Not available in this setting | $240.95 | RVU16C |
| 2016-04-01 | Not available in this setting | $240.95 | RVU16B |
| 2016-01-01 | Not available in this setting | $240.95 | RVU16A |
| 2015-10-01 | Not available in this setting | $246.22 | RVU15D |
| 2015-07-01 | Not available in this setting | $246.22 | RVU15C |
| 2015-04-01 | Not available in this setting | $245.00 | RVU15B |
| 2015-01-01 | Not available in this setting | $245.00 | RVU15A |
| 2014-10-01 | Not available in this setting | $236.35 | RVU14D |
| 2014-07-01 | Not available in this setting | $236.35 | RVU14C |
| 2014-04-01 | Not available in this setting | $236.35 | RVU14B |
| 2014-01-01 | Not available in this setting | $236.35 | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
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
43266 billing questions
Is dilation separately reported when it is performed to place the stent?
Pre- and post-dilation, along with guidewire passage when performed, are included in 43266. Do not separately report those steps as stand-alone services.
How is 43266 different from ERCP stent placement?
43266 describes stent placement during transoral EGD in the upper GI tract. Use the ERCP stent code when the stent is placed in a bile or pancreatic duct through ERCP.
What happens when another related endoscopy is performed in the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together. The claim should reflect the procedures actually performed and documented.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for 43266, and co-surgeons and team surgery are not permitted.
What documentation supports reporting 43266?
Document the clinical target and reason for stenting, the stent deployment, and any dilation performed. The record should distinguish stent placement from evaluation or dilation alone.
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
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