CPT code 43275: ERCP removal, duct stent or foreign body2026 Medicare rate & RVUs in New Mexico
During ERCP, report this service to retrieve a stent or other foreign material from a biliary or pancreatic duct without exchanging it.
In New Mexico, Medicare pays $326.84 for 43275 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 43275 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 43275 covers
During endoscopic retrograde cholangiopancreatography (ERCP), a therapeutic endoscopist uses a duodenoscope and retrieval tools to remove a stent or other foreign material from a bile duct or pancreatic duct. Common situations include removal of a retained or migrated duct stent. The service is performed in an endoscopy suite or hospital procedure room, generally by a gastroenterologist experienced in therapeutic ERCP.
Report the service when the duct foreign body or stent is actually removed; document the item, duct, and removal. If a stent is exchanged for another, distinguish that service from removal alone. Duct stones or debris are addressed by a different ERCP service. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Endoscopy family pricing applies when related endoscopies are performed together. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, 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 43275
Across 109 of 109 payment localities, the facility rate for 43275 runs from $304.81 in Arkansas to $433.83 in Alaska. New Mexico pays $326.84. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$326.84
- Los Angeles, CA · California$343.51+$16.67
- Washington, DC area · District of Columbia$357.42+$30.58
- Miami, FL · Florida$370.40+$43.56
- Chicago, IL · Illinois$363.17+$36.33
- Manhattan, NY · New York$370.39+$43.55
- Alaska · Alaska$433.83+$106.99
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $307.38 |
| ArkansasArkansas | — | $304.81 |
| ArizonaArizona | — | $322.21 |
| Bakersfield, CACalifornia | — | $330.28 |
| Chico, CACalifornia | — | $327.98 |
| El Centro, CACalifornia | — | $328.11 |
| Fresno, CACalifornia | — | $327.98 |
| Hanford, CACalifornia | — | $327.98 |
| Madera, CACalifornia | — | $327.98 |
| Merced, CACalifornia | — | $327.98 |
| Modesto, CACalifornia | — | $327.98 |
| Napa, CACalifornia | — | $355.20 |
| Oxnard, CACalifornia | — | $339.49 |
| Redding, CACalifornia | — | $327.98 |
| Rest of CaliforniaCalifornia | — | $327.98 |
| Riverside, CACalifornia | — | $336.25 |
| Sacramento, CACalifornia | — | $337.55 |
| Salinas, CACalifornia | — | $336.12 |
| San Diego, CACalifornia | — | $338.99 |
| Marin County, CACalifornia | — | $368.42 |
| San Francisco, CACalifornia | — | $367.56 |
| San Benito County, CACalifornia | — | $376.27 |
| Santa Clara County, CACalifornia | — | $372.74 |
| San Luis Obispo, CACalifornia | — | $331.40 |
| Santa Cruz, CACalifornia | — | $338.34 |
| Santa Maria, CACalifornia | — | $336.01 |
| Santa Rosa, CACalifornia | — | $341.38 |
| Stockton, CACalifornia | — | $327.98 |
| Vallejo, CACalifornia | — | $353.95 |
| Visalia, CACalifornia | — | $327.98 |
| Yuba City, CACalifornia | — | $327.98 |
| ColoradoColorado | — | $330.54 |
| ConnecticutConnecticut | — | $344.25 |
| DelawareDelaware | — | $325.93 |
| Fort Lauderdale, FLFlorida | — | $349.88 |
| Rest of FloridaFlorida | — | $337.60 |
| Atlanta, GAGeorgia | — | $335.38 |
| Rest of GeorgiaGeorgia | — | $324.62 |
| Hawaii, Guam, HIHawaii | — | $328.53 |
| IowaIowa | — | $306.27 |
| IdahoIdaho | — | $308.59 |
| East St. Louis, ILIllinois | — | $347.71 |
| Rest of IllinoisIllinois | — | $335.71 |
| Suburban Chicago, ILIllinois | — | $351.64 |
| IndianaIndiana | — | $309.48 |
| KansasKansas | — | $308.11 |
| KentuckyKentucky | — | $317.35 |
| New Orleans, LALouisiana | — | $327.09 |
| Rest of LouisianaLouisiana | — | $318.12 |
| Metropolitan Boston, MAMassachusetts | — | $350.12 |
| Rest of MassachusettsMassachusetts | — | $330.97 |
| Baltimore area, MDMaryland | — | $343.73 |
| Rest of MarylandMaryland | — | $329.44 |
| Rest of MaineMaine | — | $312.38 |
| Southern Maine, MEMaine | — | $318.25 |
| Detroit, MIMichigan | — | $342.96 |
| Rest of MichiganMichigan | — | $324.69 |
| MinnesotaMinnesota | — | $312.77 |
| Metropolitan Kansas City, MOMissouri | — | $322.90 |
| Metropolitan St. Louis, MOMissouri | — | $324.57 |
| Rest of MissouriMissouri | — | $316.70 |
| MississippiMississippi | — | $310.66 |
| MontanaMontana | — | $328.28 |
| North CarolinaNorth Carolina | — | $313.84 |
| North DakotaNorth Dakota | — | $313.25 |
| NebraskaNebraska | — | $306.42 |
| New HampshireNew Hampshire | — | $328.42 |
| Northern New JerseyNew Jersey | — | $356.85 |
| Rest of New JerseyNew Jersey | — | $347.04 |
| NevadaNevada | — | $324.17 |
| NYC suburbs and Long Island, NYNew York | — | $379.41 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $351.27 |
| Queens, NYNew York | — | $368.32 |
| Rest of New YorkNew York | — | $316.82 |
| OhioOhio | — | $321.62 |
| OklahomaOklahoma | — | $314.16 |
| Portland, OROregon | — | $334.23 |
| Rest of OregonOregon | — | $320.47 |
| Metropolitan Philadelphia, PAPennsylvania | — | $340.51 |
| Rest of PennsylvaniaPennsylvania | — | $320.42 |
| Puerto RicoPuerto Rico | — | $328.82 |
| Rhode IslandRhode Island | — | $332.46 |
| South CarolinaSouth Carolina | — | $318.48 |
| South DakotaSouth Dakota | — | $311.48 |
| TennesseeTennessee | — | $309.34 |
| Austin, TXTexas | — | $330.49 |
| Beaumont, TXTexas | — | $319.37 |
| Brazoria, TXTexas | — | $323.82 |
| Dallas, TXTexas | — | $326.42 |
| Fort Worth, TXTexas | — | $325.95 |
| Galveston, TXTexas | — | $325.20 |
| Houston, TXTexas | — | $339.11 |
| Rest of TexasTexas | — | $321.81 |
| UtahUtah | — | $320.97 |
| VirginiaVirginia | — | $319.52 |
| Virgin Islands, VIUnited States Virgin Islands | — | $328.82 |
| VermontVermont | — | $315.00 |
| Rest of WashingtonWashington | — | $329.38 |
| King County, WAWashington | — | $352.90 |
| WisconsinWisconsin | — | $307.43 |
| West VirginiaWest Virginia | — | $328.86 |
| WyomingWyoming | — | $321.73 |
43275 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 43275 rate is calculated
Each of 43275’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 · 43275
RVUs × geographic indexes × conversion factor
Work6.69
6.69 RVUs× 1.000 GPCI
Practice expense2.38
2.38 RVUs× 1.000 GPCI
Malpractice0.76
0.76 RVUs× 1.000 GPCI
Adjusted RVUs
9.8300
Conversion factor
$33.4009
Medicare rate
$328.33
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
5,199
- Code
- 43275
- Physician work
- 6.69
- Practice expense
- 2.38
- Malpractice
- 0.76
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.69 | × 1.000 | 6.6900 |
| Practice expense | 2.38 | × 0.917 | 2.1825 |
| Malpractice | 0.76 | × 1.201 | 0.9128 |
| Total RVUs | 9.7852 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$326.84
Facility: (6.69 × 1 + 2.38 × 0.917 + 0.76 × 1.201) × $33.4009 = $326.84
Payment rules and modifiers for 43275
The CMS indicators that decide how 43275 is paid alongside other services.
CMS payment indicators · 43275
ERCP removal, duct stent or foreign body
| 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
43275 without 51 · national facility
$328.33
ERCP removal, duct stent or foreign body
43275-51 · Second procedure: 50%
$164.17
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 43275 has changed in New Mexico
43275 · 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 | $326.84 | RVU26D |
| 2026-07-01 | Not available in this setting | $326.84 | RVU26C |
| 2026-04-01 | Not available in this setting | $326.84 | RVU26B |
| 2026-01-01 | Not available in this setting | $326.84 | RVU26A |
| 2025-10-01 | Not available in this setting | $353.05 | RVU25D |
| 2025-07-01 | Not available in this setting | $353.05 | RVU25C |
| 2025-04-01 | Not available in this setting | $353.05 | RVU25B |
| 2025-01-01 | Not available in this setting | $353.05 | RVU25A |
| 2024-10-01 | Not available in this setting | $362.72 | RVU24D |
| 2024-07-01 | Not available in this setting | $362.72 | RVU24C |
| 2024-04-01 | Not available in this setting | $362.72 | RVU24B |
| 2024-03-09 | Not available in this setting | $362.72 | RVU24AR |
| 2024-01-01 | Not available in this setting | $356.80 | RVU24A |
| 2023-10-01 | Not available in this setting | $366.16 | RVU23D |
| 2023-07-01 | Not available in this setting | $366.16 | RVU23C |
| 2023-04-01 | Not available in this setting | $366.16 | RVU23B |
| 2023-01-01 | Not available in this setting | $366.16 | RVU23A |
| 2022-10-01 | Not available in this setting | $372.87 | RVU22D |
| 2022-07-01 | Not available in this setting | $372.87 | RVU22C |
| 2022-04-01 | Not available in this setting | $372.87 | RVU22B |
| 2022-01-01 | Not available in this setting | $372.87 | RVU22A |
| 2021-10-01 | Not available in this setting | $374.21 | RVU21D |
| 2021-07-01 | Not available in this setting | $374.21 | RVU21C |
| 2021-04-01 | Not available in this setting | $374.21 | RVU21B |
| 2021-01-01 | Not available in this setting | $374.21 | RVU21A |
| 2020-10-01 | Not available in this setting | $386.53 | RVU20D |
| 2020-07-01 | Not available in this setting | $386.53 | RVU20C |
| 2020-04-01 | Not available in this setting | $386.53 | RVU20B |
| 2020-01-01 | Not available in this setting | $386.53 | RVU20A |
| 2019-10-01 | Not available in this setting | $396.31 | RVU19D |
| 2019-07-01 | Not available in this setting | $396.31 | RVU19C |
| 2019-04-01 | Not available in this setting | $396.31 | RVU19B |
| 2019-01-01 | Not available in this setting | $396.31 | RVU19A |
| 2018-10-01 | Not available in this setting | $397.08 | RVU18D |
| 2018-07-01 | Not available in this setting | $397.08 | RVU18C |
| 2018-04-01 | Not available in this setting | $397.08 | RVU18B |
| 2018-01-01 | Not available in this setting | $397.08 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $394.40 | RVU17D |
| 2017-07-01 | Not available in this setting | $394.40 | RVU17C |
| 2017-04-01 | Not available in this setting | $394.40 | RVU17B |
| 2017-01-01 | Not available in this setting | $394.40 | RVU17A |
| 2016-10-01 | Not available in this setting | $397.41 | RVU16D |
| 2016-07-01 | Not available in this setting | $397.41 | RVU16C |
| 2016-04-01 | Not available in this setting | $397.41 | RVU16B |
| 2016-01-01 | Not available in this setting | $397.41 | RVU16A |
| 2015-10-01 | Not available in this setting | $405.99 | RVU15D |
| 2015-07-01 | Not available in this setting | $405.99 | RVU15C |
| 2015-04-01 | Not available in this setting | $403.97 | RVU15B |
| 2015-01-01 | Not available in this setting | $403.97 | RVU15A |
| 2014-10-01 | Not available in this setting | $403.35 | RVU14D |
| 2014-07-01 | Not available in this setting | $403.35 | RVU14C |
| 2014-04-01 | Not available in this setting | $403.35 | RVU14B |
| 2014-01-01 | Not available in this setting | $403.35 | 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
43275 billing questions
When should 43275 be chosen instead of 43276?
Use 43275 for removal of a duct stent or other foreign body without stent exchange. Use 43276 when a stent is removed and exchanged for another.
Can 43275 be used to report removal of duct stones?
No. For extraction of duct calculi or debris, consider 43264; 43275 describes removal of a stent or other foreign body.
What documentation supports reporting 43275?
The ERCP report should identify the duct and the stent or foreign material removed, and describe the retrieval performed. Document whether a stent was exchanged.
Should modifier 50 be appended for removal from two ducts?
No. CMS identifies bilateral adjustment as inappropriate for this service. Document the duct or ducts treated.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's global period. Related endoscopies performed together are subject to CMS endoscopy family pricing.
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 43275 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist