No office rate
43275 reports removal without stent exchange. 43276 applies when a stent is removed and exchanged for another.
On this page
CMS RVU26D · Effective 2026-10-01
43275 ERCP removal Medicare reimbursement rates in Oregon
During ERCP, report this service to retrieve a stent or other foreign material from a biliary or pancreatic duct without exchanging it. Compare 43275 office and facility rates across CMS payment localities in Oregon.
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.
What does Medicare pay for 43275 in Oregon?
Oregon has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$320.47–$334.23
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Gastroenterology
About 43275: ERCP duct foreign-body removal
During ERCP, report this service to retrieve a stent or other foreign material from a biliary or pancreatic duct without exchanging it.
During endoscopic retrograde cholangiopancreatography (ERCP), a therapeutic endoscopist uses a duodenoscope and retrieval tools to remove a stent or other foreign material from a bile duct or pancreatic duct. Common situations include removal of a retained or migrated duct stent. The service is performed in an endoscopy suite or hospital procedure room, generally by a gastroenterologist experienced in therapeutic ERCP.
Report the service when the duct foreign body or stent is actually removed; document the item, duct, and removal. If a stent is exchanged for another, distinguish that service from removal alone. Duct stones or debris are addressed by a different ERCP service. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Endoscopy family pricing applies when related endoscopies are performed together. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 43275
- 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 RVU6.69 · 68%
- Practice expense (office) RVU2.38 · 24%
- Malpractice RVU0.76 · 8%
13.7K
Medicare services in 2024 · #1308 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.
43275 compared with similar codes
Office rates for Oregon, from the same CMS release.
No office rate
43264 describes ERCP removal of duct calculi or debris. Use 43275 for a stent or other foreign body.
No office rate
43274 is for ERCP duct stent placement. It does not describe retrieval of an existing stent or foreign body.
Compare 43275 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Portland →
Office / nonfacility
Unavailable
Facility
$334.23
Rest Of Oregon →
Office / nonfacility
Unavailable
Facility
$320.47
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43275 billing questions
When should 43275 be chosen instead of 43276?
Use 43275 for removal of a duct stent or other foreign body without stent exchange. Use 43276 when a stent is removed and exchanged for another.
Can 43275 be used to report removal of duct stones?
No. For extraction of duct calculi or debris, consider 43264; 43275 describes removal of a stent or other foreign body.
What documentation supports reporting 43275?
The ERCP report should identify the duct and the stent or foreign material removed, and describe the retrieval performed. Document whether a stent was exchanged.
Should modifier 50 be appended for removal from two ducts?
No. CMS identifies bilateral adjustment as inappropriate for this service. Document the duct or ducts treated.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's global period. Related endoscopies performed together are subject to CMS endoscopy family pricing.
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.
5,19643270,,Egd lesion ablation,A,,3.91,19.68,,1.57,,0.44,24.03,5.92,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43235,33.4009,09,0,99,0.00,0.00,0.00
5,19743273,,Endoscopic pancreatoscopy,A,,2.18,0.64,NA,0.64,,0.23,3.05,3.05,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,19843274,,Ercp duct stent placement,A,,8.27,2.85,NA,2.85,,0.92,12.04,12.04,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43260,33.4009,09,0,99,0.00,0.00,0.00
5,19943275,,Ercp remove forgn body duct,A,,6.69,2.38,NA,2.38,,0.76,9.83,9.83,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43260,33.4009,09,0,99,0.00,0.00,0.00
5,20043276,,Ercp stent exchange w/dilate,A,,8.62,2.95,NA,2.95,,0.98,12.55,12.55,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43260,33.4009,09,0,99,0.00,0.00,0.00
5,20143277,,Ercp ea duct/ampulla dilate,A,,6.73,2.40,NA,2.40,,0.75,9.88,9.88,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43260,33.4009,09,0,99,0.00,0.00,0.00
5,20243278,,Ercp lesion ablate w/dilate,A,,7.72,2.68,NA,2.68,,0.87,11.27,11.27,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43260,33.4009,09,0,99,0.00,0.00,0.00