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See a sample rate comparisonCPT 43247 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Remove Swallowed Object, Procedure Using A Scope (Endoscopy) To Remove A Foreign Object That Has Been Swallowed. The Procedure Examines The Upper Digestive Tract (Esophagus Stomach Small Intestine).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $426.20 national non-facility rate (2026) · View Medicare rates for 43247 |
| Medicaid Fee Schedule | $334.20 median of the 8 states in the free preview · View Medicaid rates for 43247 |
National average reimbursement for CPT 43247 by major payers:
$397.34
$424.25
$489.38
$315.43
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CPT 43247
5 of 25 sample ratesHigher to lower in this preview
Jan Mrani
Beloit Health System Inc
$1,336.63Published rateSyeda Hussain
South Broward Hospital District
$567.28Published rateSidrah Rafiq
Rutgers Healthrwj Primary Medicine Group
$376.67Published rateBinghua Zhu
Icare Internal Medicine, LLC
$246.69Published rateEugene Festa
Rejuvenation Center For Mind And Body
$108.04Published rate
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See a sample payer proposalCPT 43247 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 43247 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 43247 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 43215-CPT | Moderate | Esophagoscopy Rigid Or Flexib, Esophagoscopy Rigid Or Flexible With Removal Of Foreignbody Esophagoscopy Rigid Or Flexible With Removal Of Foreign |
| 43245-CPT | Moderate | Upper Gastrointestinal Endosco, Upper Gastrointestinal Endoscopy Including Esophagusstomach And Either The Duodenum Andor Jejunumas Appropriate With Dilation Of Gastric Outlet For |
| 43246-CPT | Moderate | Upper Gastrointestinal Endosco, Upper Gastrointestinal Endoscopy Including Esophagusstomach And Either The Duodenum Andor Jejunumas Appropriate With Directed Placement Of Percu Taneous |
| 43247-CPT | Moderate | Remove Swallowed Object, Procedure Using A Scope (Endoscopy) To Remove A Foreign Object That Has Been Swallowed. The Procedure Examines The Upper Digestive Tract (Esophagus Stomach Small Intestine). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 43247. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 43247 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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