Replacement of stent in pancreatic or bile duct using a flexible endoscope
Medicare pricing data for 2,391 providers across 49 states
Prices vary significantly by location — from $365 in Minnesota to $1,173 in Alaska. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Replacement of stent in pancreatic or bile duct using a flexible endoscope (HCPCS code 43276) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $424.28, but hospitals typically charge $1,930 — a 4.5x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $424.28, your out-of-pocket cost would be approximately $84.86. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 4.5x more than what Medicare allows for this procedure. Medicare actually pays $336.00 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $1,173 | $6,112 | 5 | 18 | +176.5% |
| Rhode Island | $480 | $1,357 | 7 | 25 | +13.1% |
| Delaware | $477 | $1,224 | 10 | 34 | +12.5% |
| District of Columbia | $477 | $1,515 | 7 | 125 | +12.4% |
| Maryland | $474 | $1,378 | 35 | 197 | +11.6% |
| New York | $473 | $2,469 | 145 | 796 | +11.4% |
| Nevada | $464 | $1,302 | 14 | 47 | +9.4% |
| New Jersey | $455 | $2,584 | 74 | 370 | +7.2% |
| New Hampshire | $453 | $7,000 | 11 | 77 | +6.8% |
| Illinois | $453 | $2,318 | 95 | 565 | +6.8% |
| Utah | $442 | $1,415 | 15 | 65 | +4.2% |
| Florida | $442 | $1,680 | 157 | 719 | +4.1% |
| New Mexico | $440 | $1,371 | 9 | 53 | +3.7% |
| Louisiana | $437 | $1,532 | 32 | 160 | +3.0% |
| Georgia | $434 | $1,584 | 64 | 259 | +2.2% |
| West Virginia | $433 | $1,548 | 16 | 127 | +2.1% |
| California | $432 | $1,955 | 246 | 1,987 | +1.8% |
| Wisconsin | $432 | $3,406 | 57 | 242 | +1.8% |
| Pennsylvania | $431 | $1,910 | 119 | 908 | +1.7% |
| Washington | $431 | $1,415 | 60 | 542 | +1.6% |
| Arkansas | $430 | $3,069 | 23 | 105 | +1.3% |
| Connecticut | $429 | $2,416 | 34 | 341 | +1.2% |
| Texas | $429 | $2,184 | 197 | 1,241 | +1.2% |
| South Carolina | $426 | $2,049 | 36 | 211 | +0.4% |
| Kansas | $426 | $1,247 | 15 | 132 | +0.3% |
| Kentucky | $424 | $1,218 | 34 | 224 | -0.2% |
| Hawaii | $422 | $1,119 | 7 | 27 | -0.6% |
| North Carolina | $421 | $1,609 | 68 | 422 | -0.9% |
| Maine | $419 | $1,610 | 7 | 40 | -1.4% |
| Massachusetts | $418 | $2,157 | 63 | 682 | -1.4% |
| South Dakota | $417 | $1,065 | 8 | 71 | -1.7% |
| Mississippi | $415 | $1,532 | 19 | 53 | -2.1% |
| Missouri | $415 | $1,668 | 68 | 660 | -2.3% |
| Tennessee | $414 | $1,635 | 50 | 191 | -2.4% |
| Colorado | $413 | $1,496 | 44 | 343 | -2.7% |
| Nebraska | $413 | $1,455 | 19 | 122 | -2.8% |
| Idaho | $413 | $1,061 | 18 | 47 | -2.8% |
| Alabama | $410 | $1,712 | 27 | 164 | -3.3% |
| Ohio | $410 | $1,813 | 87 | 501 | -3.5% |
| Oklahoma | $402 | $2,243 | 17 | 126 | -5.4% |
| Michigan | $399 | $1,563 | 75 | 608 | -6.1% |
| Montana | $397 | $1,316 | 11 | 80 | -6.4% |
| North Dakota | $396 | $1,701 | 8 | 49 | -6.8% |
| Iowa | $393 | $1,734 | 17 | 139 | -7.3% |
| Oregon | $391 | $1,586 | 33 | 161 | -7.8% |
| Arizona | $382 | $1,918 | 37 | 437 | -10.0% |
| Virginia | $379 | $1,375 | 56 | 570 | -10.7% |
| Indiana | $376 | $1,754 | 55 | 379 | -11.3% |
| Minnesota | $365 | $2,256 | 46 | 603 | -13.9% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
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