No office rate
Choose 43191 for diagnostic rigid transoral examination without therapeutic foreign-body extraction; choose 43194 when an object is removed.
On this page
CMS RVU26D · Effective 2026-10-01
43194 Foreign body removal Medicare reimbursement rates in Texas
Rigid transoral esophagoscopy code for endoscopic extraction of an esophageal foreign body, such as an impacted food bolus or lodged object. Compare 43194 office and facility rates across CMS payment localities in Texas.
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 43194 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No 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.
Where 43194 pays more and less in Texas
Gastrointestinal endoscopy
About 43194: Rigid esophagoscopy with foreign body removal
Rigid transoral esophagoscopy code for endoscopic extraction of an esophageal foreign body, such as an impacted food bolus or lodged object.
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.
CMS billing rules for 43194
- 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 RVU3.42 · 71%
- Practice expense (office) RVU0.94 · 19%
- Malpractice RVU0.48 · 10%
76
Medicare services in 2024 · #5096 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.
43194 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
43193 is for biopsy through a rigid transoral esophagoscope. 43194 is for extraction of a foreign body.
No office rate
43195 describes balloon dilation of the esophagus with a rigid scope, not removal of an ingested object.
$404.64–$455.35
Both codes describe endoscopic foreign-body removal, but 43215 uses a flexible transoral esophagoscope; 43194 uses a rigid one.
Compare 43194 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $161.88 |
| Beaumont | Office Unavailable | Facility $157.70 |
| Brazoria | Office Unavailable | Facility $158.76 |
| Dallas | Office Unavailable | Facility $160.29 |
| Fort Worth | Office Unavailable | Facility $160.18 |
| Galveston | Office Unavailable | Facility $159.60 |
| Houston | Office Unavailable | Facility $168.38 |
| Rest Of Texas | Office Unavailable | Facility $158.50 |
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 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.
5,13243191,,Esophagoscopy rigid trnso dx,A,,2.43,1.26,NA,1.26,,0.37,4.06,4.06,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,13343192,,Esophagoscp rig trnso inject,A,,2.72,1.28,NA,1.28,,0.40,4.40,4.40,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43191,33.4009,09,0,99,0.00,0.00,0.00
5,13443193,,Esophagoscp rig trnso biopsy,A,,2.72,1.30,NA,1.30,,0.41,4.43,4.43,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43191,33.4009,09,0,99,0.00,0.00,0.00
5,13543194,,Esophagoscp rig trnso rem fb,A,,3.42,0.94,NA,0.94,,0.48,4.84,4.84,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43191,33.4009,09,0,99,0.00,0.00,0.00
5,13643195,,Esophagoscopy rigid balloon,A,,2.99,1.35,NA,1.35,,0.43,4.77,4.77,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43191,33.4009,09,0,99,0.00,0.00,0.00
5,13743196,,Esophagoscp guide wire dilat,A,,3.23,1.46,NA,1.46,,0.45,5.14,5.14,0,000,0.00,0.00,0.00,3,0,1,0,0,9,43191,33.4009,09,0,99,0.00,0.00,0.00
5,13843197,,Esophagoscopy flex dx brush,A,,1.48,4.21,,0.36,,0.21,5.90,2.05,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00