CPT code 43276: ERCP stent exchange, with dilation2026 Medicare rate & RVUs in South Dakota

In South Dakota, Medicare pays $397.45 for 43276 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 43276 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 43276 covers

During ERCP, a gastroenterologist advances an endoscope through the mouth into the duodenum to reach a biliary or pancreatic duct. This service covers removing an existing duct stent and exchanging it for a replacement; dilation may be performed as part of that work. Exchanges may be needed when a stent is obstructed or has migrated, or as part of ongoing management of a duct stricture. ERCP is generally performed in a hospital or ambulatory endoscopy setting.

Report the service for each stent exchanged, and document the duct, stent removal and replacement, and any dilation performed. Dilation included in the exchange is not a separate service for that same work. When related endoscopies are performed together, CMS endoscopy-family pricing applies. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for this anatomy and descriptor. Medicare does not pay an assistant at surgery for this service; 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 South Dakota compares for 43276

Across 109 of 109 payment localities, the facility rate for 43276 runs from $389.41 in Arkansas to $554.85 in Alaska. South Dakota pays $397.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

43276 rates by state

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

See 43276 in every payment locality

How the 43276 rate is calculated

Each of 43276’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 43276

The CMS indicators that decide how 43276 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 43276

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

How 43276 has changed in South Dakota

Price 43276 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