43260 Ercp with specimen collection
Also known as: ERCP with specimen, pancreatic duct brushing, biliary duct biopsy, ERCP diagnostic
Endoscopic retrograde cholangiopancreatography with specimen collection for cytology or histology from pancreatic or biliary duct. This diagnostic procedure obtains tissue samples.
In Plain Language
tissue sample from bile duct; ductal brushing during ERCP
Clinical Context
Diagnostic ERCP for suspected ductal malignancy or stricture evaluation; tissue sampling improves diagnostic accuracy for pancreatic and biliary cancers.
RVU Breakdown
| Work RVU | 5.70 |
| Total RVU | 5.70 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 0-day global period, meaning pre- and post-operative E&M visits are billable separately on the same day. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 5.70, this code ranks in the 38th percentile among Surgery codes — 1.4x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 43260?
CPT 43260 (Ercp with specimen collection) is a Surgery code. Endoscopic retrograde cholangiopancreatography with specimen collection for cytology or histology from pancreatic or biliary duct. This diagnostic procedure obtains tissue samples.
What is the wRVU value for CPT 43260?
The work RVU for CPT 43260 is 5.70. This code is primarily used by Gastroenterology, Oncology, Surgery.
When is CPT 43260 used?
Diagnostic ERCP for suspected ductal malignancy or stricture evaluation; tissue sampling improves diagnostic accuracy for pancreatic and biliary cancers.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.