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43263 Ercp sphincter pressure meas

Surgery Global 0d

Also known as: ERCP manometry, sphincter pressure measurement, manometry catheter

Endoscopic retrograde cholangiopancreatography with measurement of pancreatic or biliary sphincter pressure using a manometer catheter. This diagnostic measure assesses sphincter function.

In Plain Language

pressure measurement of bile opening; sphincter pressure testing

Clinical Context

Used to diagnose sphincter of Oddi dysfunction in patients with recurrent pancreatitis or biliary-type pain; manometry findings guide sphincterotomy decisions.

RVU Breakdown

Work RVU6.34
Total RVU6.34

Est. Medicare Payment

$211.76

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 6.34, this code ranks in the 42nd percentile among Surgery codes — 1.3x below the median (8.00). The highest wRVU in this category is 106.19.

Specialties

GastroenterologySurgery

Frequently Asked Questions

What is CPT code 43263?

CPT 43263 (Ercp sphincter pressure meas) is a Surgery code. Endoscopic retrograde cholangiopancreatography with measurement of pancreatic or biliary sphincter pressure using a manometer catheter. This diagnostic measure assesses sphincter function.

What is the wRVU value for CPT 43263?

The work RVU for CPT 43263 is 6.34. This code is primarily used by Gastroenterology, Surgery.

When is CPT 43263 used?

Used to diagnose sphincter of Oddi dysfunction in patients with recurrent pancreatitis or biliary-type pain; manometry findings guide sphincterotomy decisions.

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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.