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CMS RVU26D · Effective 2026-10-01

43247 in Merced

Office / nonfacility

$452.01

Base rate per service

Facility setting

$157.32

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Gastroenterology endoscopy

About 43247: Upper GI endoscopic foreign-body removal

Reports therapeutic upper GI endoscopy to retrieve a foreign object from the esophagus, stomach, or proximal small bowel.

A gastroenterologist or other qualified endoscopist uses a flexible scope passed through the mouth to locate and retrieve a foreign object in the upper gastrointestinal tract. Common situations include removal of an impacted food bolus or a swallowed object from the esophagus or stomach. Retrieval may use an endoscopic grasping or capture device, with the approach guided by the object's location and characteristics. The service is generally performed in an endoscopy unit or hospital setting.

Report this code when the endoscopic service includes foreign-body removal, not for inspection alone. The same-session diagnostic examination that leads to removal is part of the therapeutic service; do not separately report 43235 for that inspection. Medicare 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 for this single endoscopic service. Medicare's statutory restriction bars payment for an assistant at surgery, and co-surgeon and team-surgery reporting are not permitted.

CMS billing rules for 43247

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Endoscopy family pricing applies when related endoscopies are performed together.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.03 · 24%
  • Practice expense (office) RVU9.35 · 73%
  • Malpractice RVU0.38 · 3%

23.3K

Medicare services in 2024 · #1080 by national volume

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.

43247 compared with similar codes

Office rates for Merced, from the same CMS release.

43235

Upper GI endoscopy

Diagnostic, brushings or washings

$343.76

43235 represents diagnostic EGD without therapeutic foreign-body removal. When retrieval is performed during the examination, report 43247 rather than separately reporting the diagnostic inspection.

43250

Upper endoscopy

Cautery lesion removal

$531.04

43250 describes cautery treatment of a tumor or polyp. Use 43247 for removal of a foreign object, not treatment of a tissue lesion.

43251

EGD lesion removal

Snare technique

$581.95

43251 describes snare removal of a lesion. Use 43247 when the endoscopic target is a foreign object rather than abnormal tissue.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 43247 is $453.14—$1.13 higher than the $452.01 rate in Merced. Both use the same code, release and participation basis.

43247 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $452.01

  2. Bakersfield

    $453.14

    $1.13 higher than Merced

  3. Chico

    $452.01

    The same base rate than Merced

  4. El Centro

    $452.07

    $0.06 higher than Merced

  5. Fresno

    $452.01

    The same base rate than Merced

  6. Hanford-Corcoran

    $452.01

    The same base rate than Merced

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $483.23

    $31.22 higher than Merced

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 43247 ranges from $376.01 in Arkansas to $569.47 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 43247

    Office

    $452.01

    Facility

    $157.32

    The same base rate than Merced for the office setting.

  • Modesto

    California · 43247

    Office

    $452.01

    Facility

    $157.32

    The same base rate than Merced for the office setting.

  • Napa

    California · 43247

    Office

    $525.64

    Facility

    $171.26

    $73.63 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 43247

    Office

    $481.08

    Facility

    $163.27

    $29.07 higher than Merced for the office setting.

  • Redding

    California · 43247

    Office

    $452.01

    Facility

    $157.32

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 43247

    Office

    $452.01

    Facility

    $157.32

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 43247

    Office

    $456.13

    Facility

    $161.44

    $4.12 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 43247

    Office

    $474.85

    Facility

    $162.15

    $22.84 higher than Merced for the office setting.

  • Salinas

    California · 43247

    Office

    $473.10

    Facility

    $161.47

    $21.09 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 43247

    Office

    $484.63

    Facility

    $163.05

    $32.62 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 43247

    Office

    $556.99

    Facility

    $177.87

    $104.98 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 43247

    Office

    $556.55

    Facility

    $177.44

    $104.54 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 43247

    Office

    $569.47

    Facility

    $181.75

    $117.46 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 43247

    Office

    $567.71

    Facility

    $179.99

    $115.70 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 43247

    Office

    $465.44

    Facility

    $159.19

    $13.43 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 43247

    Office

    $489.58

    Facility

    $162.89

    $37.57 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 43247

    Office

    $474.98

    Facility

    $161.47

    $22.97 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 43247

    Office

    $494.55

    Facility

    $164.37

    $42.54 higher than Merced for the office setting.

  • Stockton

    California · 43247

    Office

    $452.01

    Facility

    $157.32

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 43247

    Office

    $525.02

    Facility

    $170.64

    $73.01 higher than Merced for the office setting.

  • Visalia

    California · 43247

    Office

    $452.01

    Facility

    $157.32

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 43247

    Office

    $452.01

    Facility

    $157.32

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 43247

    Office

    $488.68

    Facility

    $171.95

    $36.67 higher than Merced for the office setting.

  • Miami

    Florida · 43247

    Office

    $458.41

    Facility

    $178.51

    $6.40 higher than Merced for the office setting.

  • Chicago

    Illinois · 43247

    Office

    $444.90

    Facility

    $174.68

    $7.11 lower than Merced for the office setting.

  • Manhattan

    New York · 43247

    Office

    $490.70

    Facility

    $178.27

    $38.69 higher than Merced for the office setting.

  • Alaska*

    Alaska · 43247

    Office

    $491.40

    Facility

    $205.04

    $39.39 higher than Merced for the office setting.

  • Alabama

    Alabama · 43247

    Office

    $381.65

    Facility

    $146.38

    $70.36 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 43247

    Office

    $376.01

    Facility

    $145.04

    $76.00 lower than Merced for the office setting.

  • Arizona

    Arizona · 43247

    Office

    $414.69

    Facility

    $154.14

    $37.32 lower than Merced for the office setting.

  • Colorado

    Colorado · 43247

    Office

    $444.62

    Facility

    $158.53

    $7.39 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 43247

    Office

    $454.93

    Facility

    $165.35

    $2.92 higher than Merced for the office setting.

  • Delaware

    Delaware · 43247

    Office

    $421.67

    Facility

    $156.02

    $30.34 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 43247

    Office

    $440.51

    Facility

    $168.14

    $11.50 lower than Merced for the office setting.

  • Rest Of Florida

    Florida · 43247

    Office

    $418.84

    Facility

    $161.79

    $33.17 lower than Merced for the office setting.

  • Atlanta

    Georgia · 43247

    Office

    $434.05

    Facility

    $160.87

    $17.96 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 43247

    Office

    $394.90

    Facility

    $155.07

    $57.11 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 43247

    Office

    $463.64

    Facility

    $157.92

    $11.63 higher than Merced for the office setting.

  • Iowa

    Iowa · 43247

    Office

    $392.00

    Facility

    $145.97

    $60.01 lower than Merced for the office setting.

  • Idaho

    Idaho · 43247

    Office

    $394.52

    Facility

    $147.16

    $57.49 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 43247

    Office

    $414.08

    Facility

    $166.71

    $37.93 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 43247

    Office

    $406.17

    Facility

    $160.69

    $45.84 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 43247

    Office

    $445.13

    Facility

    $169.00

    $6.88 lower than Merced for the office setting.

  • Indiana

    Indiana · 43247

    Office

    $396.87

    Facility

    $147.62

    $55.14 lower than Merced for the office setting.

  • Kansas

    Kansas · 43247

    Office

    $389.92

    Facility

    $146.85

    $62.09 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 43247

    Office

    $390.45

    Facility

    $151.42

    $61.56 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 43247

    Office

    $409.50

    Facility

    $156.48

    $42.51 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 43247

    Office

    $389.75

    Facility

    $151.79

    $62.26 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 43247

    Office

    $489.53

    Facility

    $168.50

    $37.52 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 43247

    Office

    $441.79

    Facility

    $158.66

    $10.22 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 43247

    Office

    $453.62

    Facility

    $165.12

    $1.61 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 43247

    Office

    $429.91

    Facility

    $157.81

    $22.10 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 43247

    Office

    $396.41

    Facility

    $149.05

    $55.60 lower than Merced for the office setting.

  • Southern Maine

    Maine · 43247

    Office

    $418.70

    Facility

    $152.24

    $33.31 lower than Merced for the office setting.

  • Detroit

    Michigan · 43247

    Office

    $423.97

    Facility

    $164.51

    $28.04 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 43247

    Office

    $400.66

    Facility

    $155.18

    $51.35 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 43247

    Office

    $426.32

    Facility

    $149.64

    $25.69 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 43247

    Office

    $406.85

    Facility

    $154.38

    $45.16 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 43247

    Office

    $411.23

    Facility

    $155.26

    $40.78 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 43247

    Office

    $382.77

    Facility

    $151.00

    $69.24 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 43247

    Office

    $379.47

    Facility

    $147.97

    $72.54 lower than Merced for the office setting.

  • Montana**

    Montana · 43247

    Office

    $426.17

    Facility

    $157.29

    $25.84 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 43247

    Office

    $400.69

    Facility

    $149.83

    $51.32 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 43247

    Office

    $418.66

    Facility

    $149.78

    $33.35 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 43247

    Office

    $394.25

    Facility

    $146.08

    $57.76 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 43247

    Office

    $437.41

    Facility

    $157.51

    $14.60 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 43247

    Office

    $483.40

    Facility

    $171.50

    $31.39 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 43247

    Office

    $460.21

    Facility

    $166.59

    $8.20 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 43247

    Office

    $402.83

    Facility

    $156.27

    $49.18 lower than Merced for the office setting.

  • Nevada**

    Nevada · 43247

    Office

    $424.39

    Facility

    $155.24

    $27.62 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 43247

    Office

    $502.57

    Facility

    $182.88

    $50.56 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 43247

    Office

    $463.08

    Facility

    $168.66

    $11.07 higher than Merced for the office setting.

  • Queens

    New York · 43247

    Office

    $495.12

    Facility

    $177.31

    $43.11 higher than Merced for the office setting.

  • Rest Of New York

    New York · 43247

    Office

    $406.81

    Facility

    $151.38

    $45.20 lower than Merced for the office setting.

  • Ohio

    Ohio · 43247

    Office

    $399.13

    Facility

    $153.64

    $52.88 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 43247

    Office

    $389.95

    Facility

    $149.84

    $62.06 lower than Merced for the office setting.

  • Portland

    Oregon · 43247

    Office

    $459.23

    Facility

    $160.51

    $7.22 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 43247

    Office

    $421.18

    Facility

    $153.37

    $30.83 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 43247

    Office

    $443.27

    Facility

    $163.37

    $8.74 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 43247

    Office

    $399.89

    Facility

    $153.06

    $52.12 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 43247

    Office

    $429.44

    Facility

    $157.61

    $22.57 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 43247

    Office

    $437.05

    Facility

    $159.30

    $14.96 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 43247

    Office

    $400.56

    Facility

    $152.11

    $51.45 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 43247

    Office

    $417.77

    Facility

    $148.89

    $34.24 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 43247

    Office

    $391.90

    Facility

    $147.49

    $60.11 lower than Merced for the office setting.

  • Austin

    Texas · 43247

    Office

    $443.06

    Facility

    $158.59

    $8.95 lower than Merced for the office setting.

  • Beaumont

    Texas · 43247

    Office

    $397.19

    Facility

    $152.51

    $54.82 lower than Merced for the office setting.

  • Brazoria

    Texas · 43247

    Office

    $421.40

    Facility

    $154.94

    $30.61 lower than Merced for the office setting.

  • Dallas

    Texas · 43247

    Office

    $424.05

    Facility

    $156.25

    $27.96 lower than Merced for the office setting.

  • Fort Worth

    Texas · 43247

    Office

    $421.10

    Facility

    $155.98

    $30.91 lower than Merced for the office setting.

  • Galveston

    Texas · 43247

    Office

    $422.64

    Facility

    $155.64

    $29.37 lower than Merced for the office setting.

  • Houston

    Texas · 43247

    Office

    $429.59

    Facility

    $162.60

    $22.42 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 43247

    Office

    $409.04

    Facility

    $153.87

    $42.97 lower than Merced for the office setting.

  • Utah

    Utah · 43247

    Office

    $406.16

    Facility

    $153.42

    $45.85 lower than Merced for the office setting.

  • Virginia

    Virginia · 43247

    Office

    $417.15

    Facility

    $152.85

    $34.86 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 43247

    Office

    $429.44

    Facility

    $157.61

    $22.57 lower than Merced for the office setting.

  • Vermont

    Vermont · 43247

    Office

    $416.80

    Facility

    $150.61

    $35.21 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 43247

    Office

    $441.03

    Facility

    $157.90

    $10.98 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 43247

    Office

    $499.82

    Facility

    $169.91

    $47.81 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 43247

    Office

    $404.30

    Facility

    $146.71

    $47.71 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 43247

    Office

    $390.75

    Facility

    $157.10

    $61.26 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 43247

    Office

    $422.90

    Facility

    $154.02

    $29.11 lower than Merced for the office setting.

See how rates vary across the country

43247 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$376.01

$510.74

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$491.401
AL$381.651
AR$376.011
AZ$414.691
CA$452.01–$569.4729
CO$444.621
CT$454.931
DC$488.681
DE$421.671
FL$418.84–$458.413
GA$394.90–$434.052
GU$463.641
HI$463.641
IA$392.001
ID$394.521
IL$406.17–$445.134
IN$396.871
KS$389.921
KY$390.451
LA$389.75–$409.502
MA$441.79–$489.532
MD$429.91–$488.683
ME$396.41–$418.702
MI$400.66–$423.972
MN$426.321
MO$382.77–$411.233
MS$379.471
MT$426.171
NC$400.691
ND$418.661
NE$394.251
NH$437.411
NJ$460.21–$483.402
NM$402.831
NV$424.391
NY$406.81–$502.575
OH$399.131
OK$389.951
OR$421.18–$459.232
PA$399.89–$443.272
PR$429.441
RI$437.051
SC$400.561
SD$417.771
TN$391.901
TX$397.19–$443.068
UT$406.161
VA$417.15–$488.682
VI$429.441
VT$416.801
WA$441.03–$499.822
WI$404.301
WV$390.751
WY$422.901

Explore 43247 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 43247 in Merced, the physician’s office rate is $452.01 and the facility-setting rate is $157.32: a difference of $294.69.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 43247 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$497.21

$452.01 × 110% = $497.21

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 43247 in Merced.

PPRRVU2026_Oct_nonQPP.csv

5,175

Code
43247
Physician work
3.03
Practice expense
9.35
Malpractice
0.38

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 43247 in Merced
ComponentRVULocality factorAdjusted
Physician work3.03× 1.0173.0815
Practice expense9.35× 1.09610.2476
Malpractice0.38× 0.5360.2037
Total RVUs13.5328
Conversion factor× 33.4009

Office / nonfacility rate, Merced$452.01

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 43247 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.031.017
Practice expense9.351.096
Malpractice0.380.536

(3.03 × 1.017 + 9.35 × 1.096 + 0.38 × 0.536) × $33.4009 = $452.01

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.031.017
Practice expense1.31.096
Malpractice0.380.536

(3.03 × 1.017 + 1.3 × 1.096 + 0.38 × 0.536) × $33.4009 = $157.32

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

43247 · Office / nonfacility

$452.01

Effective 2026-10-01

The base rate is $66.28 higher than on 2025-10-01, moving from $385.73 to $452.01 (17.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $385.73changed to$452.01

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.11 changed to 3.03
    • Practice expense RVU 7.82 changed to 9.35
    • Malpractice RVU 0.40 changed to 0.38
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $385.73

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$452.01$157.32RVU26D
2026-07-01$452.01$157.32RVU26C
2026-04-01$452.01$157.32RVU26B
2026-01-01$452.01$157.32RVU26A
2025-10-01$385.73$170.06RVU25D
2025-07-01$385.73$170.06RVU25C
2025-04-01$385.73$170.06RVU25B
2025-01-01$385.73$170.06RVU25A

43247 billing questions

When should 43247 be reported instead of 43235?

Report 43247 when the endoscopist retrieves a foreign object. Use 43235 for a diagnostic examination when no therapeutic removal is performed.

Can 43235 be billed with 43247 for the same examination?

The diagnostic inspection leading to foreign-body removal is included in the therapeutic service. Do not separately report 43235 for that same-session inspection.

How should removal of a lesion be distinguished from foreign-body retrieval?

43247 is for retrieval of a foreign object. Codes such as 43250 or 43251 describe treatment or removal of a tissue lesion, not foreign-body extraction.

Should modifier 50 be appended when an object is removed from a paired structure?

No. Modifier 50 is inappropriate for this endoscopic service.

What documentation supports reporting 43247?

Document the foreign object's location, the endoscopic retrieval performed, and the outcome. The record should distinguish retrieval from diagnostic inspection or treatment of a tissue lesion.

How are related endoscopies handled when performed together?

Medicare endoscopy family pricing applies when related endoscopies are performed together. The code is not an add-on code.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 43247PPRRVU2026_Oct_nonQPP.csv, line 5,175 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet