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Billing code 43194: Foreign body removalMedicare rate & RVUs

Rigid transoral esophagoscopy code for endoscopic extraction of an esophageal foreign body, such as an impacted food bolus or lodged object.

CMS RVU26DEffective Oct 1, 2026109 payment localities76 Medicare services in 2024

Medicare pays $161.66 for 43194 nationally in a facility.

Medicare rate · 43194

Foreign body removal

Work RVUs
3.42
Total RVUs
4.84
Global days
000

National rate · 2026

$161.66

Facility setting, before claim adjustments.

See every locality for 43194 →Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 43194 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 43194 covers

An otolaryngologist or thoracic surgeon passes a rigid endoscope through the mouth to inspect the esophagus and extract an ingested object. Typical cases include an impacted food bolus or a lodged bone or other foreign material requiring endoscopic removal, often in a hospital operating room. The code represents therapeutic extraction, not inspection alone, and differs from flexible-scope retrieval.

Report 43194 when the documented procedure uses the rigid transoral approach and removes a foreign body from the esophagus. The operative note should identify the approach, esophageal finding, and removal performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy-family pricing applies. Modifier 50 is inappropriate. A statutory restriction prevents payment for an assistant at surgery; 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.

Where 43194 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

43194 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$150.78
Alaska*Unavailable$213.62
ArizonaUnavailable$158.38
ArkansasUnavailable$149.46
AtlantaUnavailable$165.73
AustinUnavailable$161.88
BakersfieldUnavailable$160.58
Baltimore/Surr. CntysUnavailable$169.58
BeaumontUnavailable$157.70
BrazoriaUnavailable$158.76

43194 rates by state

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

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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
43194 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 43194 rate is calculated

Each of 43194’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 · 43194

RVUs × geographic indexes × conversion factor

Work3.42

3.42 RVUs× 1.000 GPCI

Practice expense0.94

0.94 RVUs× 1.000 GPCI

Malpractice0.48

0.48 RVUs× 1.000 GPCI

Adjusted RVUs

4.8400

Conversion factor

$33.4009

Medicare rate

$161.66

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 43194

The CMS indicators that decide how 43194 is paid alongside other services.

CMS payment indicators · 43194

Foreign body removal

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

43194 without 51 · national facility

$161.66

Foreign body removal

43194-51 · Second procedure: 50%

$80.83

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%).

When to use modifier 51

43194 compared with similar codes

Compare codes · National

5 codes, side by side

  • 43194

    Foreign body removal3.42 wRVU

    Not priced

  • 43191

    Esophagoscopy2.43 wRVU

    Not priced

  • 43193

    Esophagoscopy2.72 wRVU

    Not priced

  • 43195

    Esophageal dilation2.99 wRVU

    Not priced

  • 43215

    Object removal2.38 wRVU

    $436.55

How to choose

43191Esophagoscopy
Choose 43191 for diagnostic rigid transoral examination without therapeutic foreign-body extraction; choose 43194 when an object is removed.
43193Esophagoscopy
43193 is for biopsy through a rigid transoral esophagoscope. 43194 is for extraction of a foreign body.
43195Esophageal dilation
43195 describes balloon dilation of the esophagus with a rigid scope, not removal of an ingested object.
43215Object removal
Both codes describe endoscopic foreign-body removal, but 43215 uses a flexible transoral esophagoscope; 43194 uses a rigid one.

Codes related to 43194

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

Codes related to 43194
CodeHow it relatesNational office range
Same family
43191EsophagoscopyRigid transoral esophagoscopy for diagnostic examination without foreign-body removal.No office rate
43193EsophagoscopyRigid transoral esophagoscopy with biopsy rather than foreign-body extraction.No office rate
43195Esophageal dilationRigid esophagoscopy with balloon dilation, a different therapeutic service.No office rate
43196Esophageal dilationRigid esophagoscopy with guide-wire dilation rather than foreign-body removal.No office rate
Used instead
43215Object removalFlexible transoral esophagoscopy with foreign-body removal.$382.07–$592.22

43194 billing questions

Can 43194 be reported for removal of an impacted food bolus?

Yes, when the surgeon uses a rigid transoral esophagoscope to remove it. The documented approach and therapeutic removal distinguish this service from diagnostic examination.

How does 43194 differ from 43191?

43194 includes removal of an esophageal foreign body using the rigid transoral approach. 43191 describes diagnostic rigid transoral esophagoscopy without that therapeutic removal.

When would 43215 be a better choice?

Use 43215 when foreign-body removal is performed with a flexible transoral esophagoscope. Code 43194 is for the rigid transoral approach.

Can a related endoscopy be reported in the same session?

When related endoscopies are performed together, CMS endoscopy-family pricing applies. The documentation should support each service performed.

Which assistant or team modifiers are appropriate?

CMS does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate for this descriptor and anatomy.

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
RVUs for 43194PPRRVU2026_Oct_nonQPP.csv, line 5,135 (RVU26D)

Open CMS sourceHow we calculate rates

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