CPT code 43274: ERCP stenting, biliary or pancreatic duct2026 Medicare rate & RVUs in South Dakota

In South Dakota, Medicare pays $381.74 for 43274 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 43274 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 43274 covers

During ERCP, a gastroenterologist advances a side-viewing endoscope through the mouth to the duodenum, accesses the biliary or pancreatic duct, and places a stent to maintain drainage or passage. Typical situations include duct narrowing, obstruction, or a leak requiring endoscopic drainage. The service is most often performed in a hospital or ambulatory endoscopy facility.

Report 43274 when the procedure includes ductal stent placement. The operative report should identify the duct treated, the reason for stenting, and the placement performed. Guidewire passage, pre- or post-dilation, and sphincterotomy are included when performed as part of this service. The code has 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 for this code; Medicare also does not pay an assistant at surgery, co-surgeons, or a surgical team for it.

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 South Dakota compares for 43274

Across 109 of 109 payment localities, the facility rate for 43274 runs from $373.82 in Arkansas to $532.65 in Alaska. South Dakota pays $381.74. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

43274 rates by state

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

See 43274 in every payment locality

How the 43274 rate is calculated

Each of 43274’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 43274

The CMS indicators that decide how 43274 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 43274

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

How 43274 has changed in South Dakota

Price 43274 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

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