CPT code 43757: Duodenal aspiration, multiple specimens2026 Medicare rate & RVUs
Reports diagnostic collection of multiple aspirate specimens from the duodenum by intubation, such as sampling contents for laboratory analysis.
Medicare pays $407.82 for 43757 nationally in the office and $70.14 in a hospital or facility. Local office rates run $354.51–$570.21.
Medicare rate · 43757
Duodenal aspiration, multiple specimens
- Work RVUs
- 1.23
- Total RVUs
- 12.21
- Global days
- 000
National rate · 2026
$407.82
Office setting, before claim adjustments.
See every locality for 43757 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 10 sections
What 43757 covers
A clinician advances an intubation tube into the duodenum and collects multiple aspirate specimens for diagnostic testing. Gastroenterologists and other physicians performing gastrointestinal diagnostic procedures may use this service when duodenal contents need laboratory assessment, including evaluation for suspected small-intestinal bacterial overgrowth. The service involves aspiration of duodenal contents rather than tissue sampling by biopsy.
Select this code when the documented procedure collects multiple diagnostic specimens from the duodenum; a single-specimen collection is represented by 43756. The record should identify the duodenal sampling site, diagnostic purpose, and collection of multiple specimens. 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 43757 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$354.51 to $570.21
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $360.54 | $65.06 |
| Alaska | $449.80 | $90.17 |
| Arizona | $395.93 | $68.71 |
| Arkansas | $354.51 | $64.44 |
| Atlanta, GA | $414.68 | $71.60 |
| Austin, TX | $428.37 | $71.11 |
| Bakersfield, CA | $441.54 | $71.43 |
| Baltimore area, MD | $436.02 | $73.69 |
| Beaumont, TX | $374.91 | $67.62 |
| Brazoria, TX | $403.87 | $69.22 |
| Chicago, IL | $415.98 | $76.61 |
| Chico, CA | $441.11 | $71.01 |
| Colorado | $430.47 | $71.17 |
| Connecticut | $437.51 | $73.82 |
| Dallas, TX | $406.08 | $69.75 |
| Delaware | $403.21 | $69.58 |
| Detroit, MI | $398.36 | $72.50 |
| East St. Louis, IL | $383.60 | $72.93 |
| El Centro, CA | $441.14 | $71.03 |
| Fort Lauderdale, FL | $416.31 | $74.24 |
| Fort Worth, TX | $402.52 | $69.57 |
| Fresno, CA | $441.11 | $71.01 |
| Galveston, TX | $404.81 | $69.50 |
| Hanford, CA | $441.11 | $71.01 |
| Hawaii, Guam, HI | $455.46 | $71.51 |
| Houston, TX | $407.38 | $72.06 |
| Idaho | $376.40 | $65.73 |
| Indiana | $378.99 | $65.96 |
| Iowa | $374.23 | $65.25 |
| Kansas | $370.75 | $65.48 |
| Kentucky | $367.24 | $67.04 |
| King County, WA | $491.21 | $76.88 |
| Los Angeles, CA | $474.20 | $74.72 |
| Madera, CA | $441.11 | $71.01 |
| Manhattan, NY | $471.85 | $79.46 |
| Marin County, CA | $557.65 | $81.51 |
| Merced, CA | $441.11 | $71.01 |
| Metropolitan Boston, MA | $479.24 | $76.04 |
| Metropolitan Kansas City, MO | $385.63 | $68.55 |
| Metropolitan Philadelphia, PA | $424.31 | $72.78 |
| Metropolitan St. Louis, MO | $390.46 | $68.98 |
| Miami, FL | $429.82 | $78.29 |
| Minnesota | $415.03 | $67.56 |
| Mississippi | $356.28 | $65.53 |
| Modesto, CA | $441.11 | $71.01 |
| Montana | $407.82 | $70.13 |
| Napa, CA | $523.25 | $78.18 |
| Nebraska | $377.04 | $65.36 |
| Nevada | $407.41 | $69.39 |
| New Hampshire | $422.09 | $70.56 |
| New Mexico | $378.71 | $69.06 |
| New Orleans, LA | $387.10 | $69.34 |
| North Carolina | $381.88 | $66.82 |
| North Dakota | $405.05 | $67.36 |
| Northern New Jersey | $468.66 | $76.95 |
| NYC suburbs and Long Island, NY | $482.89 | $81.39 |
| Ohio | $376.36 | $68.06 |
| Oklahoma | $368.04 | $66.49 |
| Oxnard, CA | $473.11 | $73.97 |
| Portland, OR | $447.47 | $72.31 |
| Poughkeepsie and northern NYC suburbs, NY | $445.05 | $75.29 |
| Puerto Rico | $411.74 | $70.34 |
| Queens, NY | $478.42 | $79.28 |
| Redding, CA | $441.11 | $71.01 |
| Rest of California | $441.11 | $71.01 |
| Rest of Florida | $394.25 | $71.42 |
| Rest of Georgia | $369.62 | $68.41 |
| Rest of Illinois | $378.96 | $70.65 |
| Rest of Louisiana | $365.99 | $67.14 |
| Rest of Maine | $377.09 | $66.42 |
| Rest of Maryland | $412.20 | $70.46 |
| Rest of Massachusetts | $426.72 | $71.14 |
| Rest of Michigan | $376.93 | $68.62 |
| Rest of Missouri | $357.74 | $66.66 |
| Rest of New Jersey | $443.23 | $74.48 |
| Rest of New York | $388.33 | $67.53 |
| Rest of Oregon | $404.99 | $68.66 |
| Rest of Pennsylvania | $377.88 | $67.89 |
| Rest of Texas | $388.91 | $68.44 |
| Rest of Washington | $426.43 | $70.85 |
| Rhode Island | $420.05 | $71.22 |
| Riverside, CA | $442.64 | $72.53 |
| Sacramento, CA | $466.15 | $73.43 |
| Salinas, CA | $464.50 | $73.12 |
| San Benito County, CA | $570.21 | $83.27 |
| San Diego, CA | $477.88 | $74.01 |
| San Francisco, CA | $557.49 | $81.35 |
| San Luis Obispo, CA | $456.68 | $72.06 |
| Santa Clara County, CA | $569.56 | $82.62 |
| Santa Cruz, CA | $484.36 | $74.08 |
| Santa Maria, CA | $466.91 | $73.17 |
| Santa Rosa, CA | $489.44 | $74.76 |
| South Carolina | $379.61 | $67.59 |
| South Dakota | $404.72 | $67.04 |
| Southern Maine, ME | $402.84 | $68.20 |
| Stockton, CA | $441.11 | $71.01 |
| Suburban Chicago, IL | $421.50 | $74.70 |
| Tennessee | $372.71 | $65.76 |
| Utah | $385.62 | $68.20 |
| Vallejo, CA | $523.02 | $77.95 |
| Vermont | $401.89 | $67.59 |
| Virgin Islands, VI | $411.74 | $70.34 |
| Virginia | $400.30 | $68.35 |
| Visalia, CA | $441.11 | $71.01 |
| Washington, DC area | $475.02 | $77.23 |
| West Virginia | $362.41 | $68.96 |
| Wisconsin | $389.38 | $65.88 |
| Wyoming | $406.61 | $68.93 |
| Yuba City, CA | $441.11 | $71.01 |
43757 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$354.51
$505.66
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $449.80 | 1 |
| AL | $360.54 | 1 |
| AR | $354.51 | 1 |
| AZ | $395.93 | 1 |
| CA | $441.11–$570.21 | 29 |
| CO | $430.47 | 1 |
| CT | $437.51 | 1 |
| DC | $475.02 | 1 |
| DE | $403.21 | 1 |
| FL | $394.25–$429.82 | 3 |
| GA | $369.62–$414.68 | 2 |
| GU | $455.46 | 1 |
| HI | $455.46 | 1 |
| IA | $374.23 | 1 |
| ID | $376.40 | 1 |
| IL | $378.96–$421.50 | 4 |
| IN | $378.99 | 1 |
| KS | $370.75 | 1 |
| KY | $367.24 | 1 |
| LA | $365.99–$387.10 | 2 |
| MA | $426.72–$479.24 | 2 |
| MD | $412.20–$475.02 | 3 |
| ME | $377.09–$402.84 | 2 |
| MI | $376.93–$398.36 | 2 |
| MN | $415.03 | 1 |
| MO | $357.74–$390.46 | 3 |
| MS | $356.28 | 1 |
| MT | $407.82 | 1 |
| NC | $381.88 | 1 |
| ND | $405.05 | 1 |
| NE | $377.04 | 1 |
| NH | $422.09 | 1 |
| NJ | $443.23–$468.66 | 2 |
| NM | $378.71 | 1 |
| NV | $407.41 | 1 |
| NY | $388.33–$482.89 | 5 |
| OH | $376.36 | 1 |
| OK | $368.04 | 1 |
| OR | $404.99–$447.47 | 2 |
| PA | $377.88–$424.31 | 2 |
| PR | $411.74 | 1 |
| RI | $420.05 | 1 |
| SC | $379.61 | 1 |
| SD | $404.72 | 1 |
| TN | $372.71 | 1 |
| TX | $374.91–$428.37 | 8 |
| UT | $385.62 | 1 |
| VA | $400.30–$475.02 | 2 |
| VI | $411.74 | 1 |
| VT | $401.89 | 1 |
| WA | $426.43–$491.21 | 2 |
| WI | $389.38 | 1 |
| WV | $362.41 | 1 |
| WY | $406.61 | 1 |
How the 43757 rate is calculated
Each of 43757’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 · 43757
RVUs × geographic indexes × conversion factor
Work1.23
1.23 RVUs× 1.000 GPCI
Practice expense10.84
10.84 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
12.2100
Conversion factor
$33.4009
Medicare rate
$407.82
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43757
The CMS indicators that decide how 43757 is paid alongside other services.
CMS payment indicators · 43757
Duodenal aspiration, multiple specimens
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
43757 without 80 · national office
$407.82
Duodenal aspiration, multiple specimens
43757-80 · Assistant: 16%
$65.25
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
43757 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 43756Duodenal aspirationSingle specimen
- Choose 43757 when multiple diagnostic specimens are collected from the duodenum; 43756 describes a single specimen.
- 43755Gastric aspirationMultiple diagnostic specimens
- 43755 is diagnostic aspiration from the stomach. Use 43757 for multiple diagnostic specimens collected from the duodenum.
- 43754Gastric aspirationSingle specimen
- 43754 describes therapeutic gastric intubation and aspiration, not multiple diagnostic specimens collected from the duodenum.
43757 billing questions
How does this differ from 43756?
Both describe diagnostic duodenal aspiration. Use 43757 for multiple specimens and 43756 for a single specimen.
Can each specimen be billed as a separate unit?
The multiple-specimen code represents the diagnostic collection of multiple specimens. Document the collection clearly rather than counting each specimen as a separate service.
How does this differ from 43755?
Code 43755 is for diagnostic aspiration from the stomach. Code 43757 is for multiple diagnostic specimens collected from the duodenum.
Is same-day preoperative or postoperative care included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be reported?
CMS allows payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this 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 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
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