CPT code 43756: Duodenal aspiration, single specimen2026 Medicare rate & RVUs in New Jersey

Reports diagnostic passage of a tube into the duodenum to aspirate one specimen of duodenal contents for laboratory evaluation.

CMS RVU26DEffective Oct 1, 20262 payment localities

Medicare pays $329.89–$349.16 for 43756 in the office in New Jersey, from Rest of New Jersey to Northern New Jersey. Which amount applies depends on the service address.

$329.89–$349.16Office (non-facility)
$50.14–$51.99Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in New Jersey
  2. What 43756 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 43756 covers

A clinician passes an intubation tube into the duodenum and aspirates duodenal contents for diagnostic testing. The service may be performed when a specimen of duodenal fluid is needed for laboratory evaluation; it is distinct from collecting gastric contents or placing a tube for therapeutic use. The code is for one specimen, making specimen count a key distinction from its duodenal sibling code.

Report the service when documentation supports diagnostic duodenal intubation and aspiration of a single specimen. The record should identify the duodenal site, the diagnostic purpose, and the specimen obtained. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate for this service.

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 43756 pays more and less in New Jersey

43756 office and facility rates by payment locality
Payment localityOfficeFacility
Northern New Jersey$349.16$51.99
Rest of New Jersey$329.89$50.14

How the 43756 rate is calculated

Each of 43756’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 · 43756

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.75

0.75 RVUs× 1.000 GPCI

Practice expense8.26

8.26 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

9.0800

Conversion factor

$33.4009

Medicare rate

$303.28

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

Payment rules and modifiers for 43756

The CMS indicators that decide how 43756 is paid alongside other services.

CMS payment indicators · 43756

Duodenal aspiration, single specimen

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

43756 without 80 · national office

$303.28

Duodenal aspiration, single specimen

43756-80 · Assistant: 16%

$48.52

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

43756 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 43756

    Duodenal aspiration, single specimen0.75 wRVU

    $303.28

  • 43757

    Duodenal aspiration, multiple specimens1.23 wRVU

    $407.82+$104.54

  • 43754

    Gastric aspiration, single specimen0.44 wRVU

    $339.35+$36.07

  • 43755

    Gastric aspiration, multiple diagnostic specimens0.92 wRVU

    $224.45−$78.83

  • 43753

    Gastric aspiration, therapeutic decompression0.44 wRVU

    Not priced

How to choose

43757Duodenal aspirationMultiple specimens
Both codes describe diagnostic duodenal intubation with aspiration. Choose 43756 for one specimen and 43757 when multiple specimens are obtained.
43754Gastric aspirationSingle specimen
43754 is for diagnostic aspiration of a gastric specimen; 43756 is for a duodenal specimen.
43755Gastric aspirationMultiple diagnostic specimens
43755 covers multiple diagnostic gastric specimens. 43756 concerns a single specimen from the duodenum.
43753Gastric aspirationTherapeutic decompression
43753 describes therapeutic gastric intubation with aspiration. 43756 is diagnostic sampling from the duodenum.

43756 billing questions

When should 43756 be chosen over 43757?

Use 43756 for aspiration of one diagnostic duodenal specimen. The related 43757 code is for multiple specimens.

How does this differ from gastric intubation codes?

43756 involves diagnostic intubation and aspiration in the duodenum. Codes 43754 and 43755 concern gastric specimens, with the specimen count distinguishing those codes.

Can tube placement be billed separately?

The intubation and aspiration are part of this diagnostic service. Do not separately report a tube-placement service for the same intubation.

What documentation supports reporting 43756?

Document that the tube reached the duodenum, that aspiration was performed for diagnostic evaluation, and that one specimen was obtained.

Can modifier 50 be used, or can co-surgeons be reported?

Modifier 50 is inappropriate for this service. CMS does not permit co-surgeons or team surgery; an assistant at surgery may be paid.

What care is included in the global period?

The service has a 0-day global period, which includes same-day preoperative and postoperative care.

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 43756PPRRVU2026_Oct_nonQPP.csv, line 5,287 (RVU26D)

Open CMS sourceHow we calculate rates

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