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CPT code 43757: Duodenal aspiration, multiple specimens2026 Medicare rate & RVUs in Hawaii, Guam, HI

Reports diagnostic collection of multiple aspirate specimens from the duodenum by intubation, such as sampling contents for laboratory analysis.

CMS RVU26DEffective Oct 1, 2026One payment locality31 Medicare services in 2024

In Hawaii, Guam, HI, Medicare pays $455.46 for 43757 in the office and $71.51 when it’s performed in a hospital or facility.

$455.46Office (non-facility)
$71.51Hospital or facility
+11.7%vs the national office rate ($407.82)

Check a contract rate as a % of Medicare · 43757 nationwide

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

We’ll open 43757 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Hawaii, Guam, HI
  2. What 43757 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Hawaii, Guam, HI compares for 43757

Across 109 of 109 payment localities, the office rate for 43757 runs from $354.51 in Arkansas to $570.21 in San Benito County, CA. Hawaii, Guam, HI pays $455.46. The RVUs are the same everywhere; the geographic indexes change the dollars.

43757 in Hawaii, Guam, HI vs other payment areas
  1. Hawaii, Guam, HI · this page$455.46
  2. Los Angeles, CA · California$474.20+$18.74
  3. Washington, DC area · District of Columbia$475.02+$19.56
  4. Miami, FL · Florida$429.82−$25.64
  5. Chicago, IL · Illinois$415.98−$39.48
  6. Manhattan, NY · New York$471.85+$16.39
  7. Alaska · Alaska$449.80−$5.66

Other areas in Hawaii first, then benchmark localities. Bars start at $0.

Every other payment area

43757 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$360.54$65.06
ArkansasArkansas$354.51$64.44
ArizonaArizona$395.93$68.71
Bakersfield, CACalifornia$441.54$71.43
Chico, CACalifornia$441.11$71.01
El Centro, CACalifornia$441.14$71.03
Fresno, CACalifornia$441.11$71.01
Hanford, CACalifornia$441.11$71.01

43757 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
43757 office rate range by state
State / territoryOffice rate rangeLocalities
AK$449.801
AL$360.541
AR$354.511
AZ$395.931
CA$441.11–$570.2129
CO$430.471
CT$437.511
DC$475.021
DE$403.211
FL$394.25–$429.823
GA$369.62–$414.682
GU$455.461
HI$455.461
IA$374.231
ID$376.401
IL$378.96–$421.504
IN$378.991
KS$370.751
KY$367.241
LA$365.99–$387.102
MA$426.72–$479.242
MD$412.20–$475.023
ME$377.09–$402.842
MI$376.93–$398.362
MN$415.031
MO$357.74–$390.463
MS$356.281
MT$407.821
NC$381.881
ND$405.051
NE$377.041
NH$422.091
NJ$443.23–$468.662
NM$378.711
NV$407.411
NY$388.33–$482.895
OH$376.361
OK$368.041
OR$404.99–$447.472
PA$377.88–$424.312
PR$411.741
RI$420.051
SC$379.611
SD$404.721
TN$372.711
TX$374.91–$428.378
UT$385.621
VA$400.30–$475.022
VI$411.741
VT$401.891
WA$426.43–$491.212
WI$389.381
WV$362.411
WY$406.611

See 43757 in every payment locality

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

Office or facility?

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.

The exact Hawaii, Guam, HI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,288

Code
43757
Physician work
1.23
Practice expense
10.84
Malpractice
0.14

GPCI2026.csv

46

Locality
Hawaii, Guam, HI
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Office calculation for 43757 in Hawaii, Guam, HI
ComponentRVULocality factorAdjusted
Physician work1.23× 1.0001.2300
Practice expense10.84× 1.13712.3251
Malpractice0.14× 0.5790.0811
Total RVUs13.6361
Conversion factor× 33.4009

Office rate, Hawaii, Guam, HI$455.46

Office: (1.23 × 1 + 10.84 × 1.137 + 0.14 × 0.579) × $33.4009 = $455.46

Facility: (1.23 × 1 + 0.73 × 1.137 + 0.14 × 0.579) × $33.4009 = $71.51

Open 43757 in the RVU calculator

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

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

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.

When to use modifier 80

Codes related to 43757

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 43757
CodeHow it relatesOffice range, Hawaii, Guam, HI
Same family
43756Duodenal aspiration, single specimenDiagnostic duodenal aspiration for a single specimen.$340.09
43755Gastric aspiration, multiple diagnostic specimensDiagnostic aspiration for multiple specimens, with the stomach as the sampling site.$249.32
43754Gastric aspiration, single specimenTherapeutic gastric intubation and aspiration rather than diagnostic duodenal sampling.$381.78

How 43757 has changed in Hawaii, Guam, HI

43757 · Office / nonfacility

$455.46

Effective 2026-10-01

The base rate is $68.01 higher than on 2025-10-01, moving from $387.45 to $455.46 (17.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $387.45changed to$455.46

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.26 changed to 1.23
    • Practice expense RVU 9.25 changed to 10.84
    • Malpractice RVU 0.16 changed to 0.14
    • Practice expense GPCI 1.149 changed to 1.137
    • Malpractice GPCI 0.561 changed to 0.579

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $414.98changed to$387.45

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.68 changed to 9.25
    • Malpractice RVU 0.15 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $408.20changed to$414.98

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $427.74changed to$408.20

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.82 changed to 9.68
    • Malpractice RVU 0.17 changed to 0.15
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 1.146 changed to 1.149
    • Malpractice GPCI 0.618 changed to 0.561

  5. January 1, 2023

    RVU23A

    $450.70changed to$427.74

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.21 changed to 9.82
    • Malpractice RVU 0.12 changed to 0.17
    • Work GPCI 1.010 changed to 1.003
    • Practice expense GPCI 1.143 changed to 1.146
    • Malpractice GPCI 0.675 changed to 0.618

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $441.35changed to$450.70

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.87 changed to 10.21
    • Malpractice RVU 0.14 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $394.34changed to$441.35

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.37 changed to 9.87
    • Malpractice RVU 0.13 changed to 0.14
    • Work GPCI 1.006 changed to 1.010
    • Practice expense GPCI 1.144 changed to 1.143
    • Malpractice GPCI 0.644 changed to 0.675

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $365.36changed to$394.34

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.66 changed to 8.37
    • Malpractice RVU 0.16 changed to 0.13
    • Work GPCI 1.001 changed to 1.006
    • Practice expense GPCI 1.146 changed to 1.144
    • Malpractice GPCI 0.614 changed to 0.644

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $335.67changed to$365.36

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.95 changed to 7.66

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $332.13changed to$335.67

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.84 changed to 6.95
    • Work GPCI 1.002 changed to 1.001
    • Practice expense GPCI 1.154 changed to 1.146
    • Malpractice GPCI 0.616 changed to 0.614

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $332.95changed to$332.13

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.83 changed to 6.84
    • Work GPCI 1.003 changed to 1.002
    • Practice expense GPCI 1.162 changed to 1.154
    • Malpractice GPCI 0.618 changed to 0.616

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $340.86changed to$332.95

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.98 changed to 6.83
    • Malpractice RVU 0.18 changed to 0.16

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $339.16changed to$340.86

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $339.57changed to$339.16

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.05 changed to 6.98
    • Malpractice RVU 0.08 changed to 0.18
    • Work GPCI 1.002 changed to 1.003
    • Practice expense GPCI 1.158 changed to 1.162
    • Malpractice GPCI 0.659 changed to 0.618

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $366.73changed to$339.57

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.20 changed to 7.05
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.700 changed to 0.659

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$366.73

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$455.46$71.51RVU26D
2026-07-01$455.46$71.51RVU26C
2026-04-01$455.46$71.51RVU26B
2026-01-01$455.46$71.51RVU26A
2025-10-01$387.45$76.37RVU25D
2025-07-01$387.45$76.37RVU25C
2025-04-01$387.45$76.37RVU25B
2025-01-01$387.45$76.37RVU25A
2024-10-01$414.98$78.40RVU24D
2024-07-01$414.98$78.40RVU24C
2024-04-01$414.98$78.40RVU24B
2024-03-09$414.98$78.40RVU24AR
2024-01-01$408.20$77.12RVU24A
2023-10-01$427.74$79.40RVU23D
2023-07-01$427.74$79.40RVU23C
2023-04-01$427.74$79.40RVU23B
2023-01-01$427.74$79.40RVU23A
2022-10-01$450.70$80.46RVU22D
2022-07-01$450.70$80.46RVU22C
2022-04-01$450.70$80.46RVU22B
2022-01-01$450.70$80.46RVU22A
2021-10-01$441.35$80.81RVU21D
2021-07-01$441.35$80.81RVU21C
2021-04-01$441.35$80.81RVU21B
2021-01-01$441.35$80.81RVU21A
2020-10-01$394.34$82.21RVU20D
2020-07-01$394.34$82.21RVU20C
2020-04-01$394.34$82.21RVU20B
2020-01-01$394.34$82.21RVU20A
2019-10-01$365.36$82.45RVU19D
2019-07-01$365.36$82.45RVU19C
2019-04-01$365.36$82.45RVU19B
2019-01-01$365.36$82.45RVU19A
2018-10-01$335.67$83.18RVU18D
2018-07-01$335.67$83.18RVU18C
2018-04-01$335.67$83.18RVU18B
2018-01-01$335.67$83.18RVU18AR1
2017-10-01$332.13$83.22RVU17D
2017-07-01$332.13$83.22RVU17C
2017-04-01$332.13$83.22RVU17B
2017-01-01$332.13$83.22RVU17A
2016-10-01$332.95$83.32RVU16D
2016-07-01$332.95$83.32RVU16C
2016-04-01$332.95$83.32RVU16B
2016-01-01$332.95$83.32RVU16A
2015-10-01$340.86$85.32RVU15D
2015-07-01$340.86$85.32RVU15C
2015-04-01$339.16$84.89RVU15B
2015-01-01$339.16$84.89RVU15A
2014-10-01$339.57$83.21RVU14D
2014-07-01$339.57$83.21RVU14C
2014-04-01$339.57$83.21RVU14B
2014-01-01$339.57$83.21RVU14A
2013-10-01$366.73$83.64RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 43757 for an earlier date of service

Where the Hawaii, Guam, HI rate applies

Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.

  • Ahuimanu
  • Aiea
  • Ainaloa
  • Anahola
  • Black Sands
  • Captain Cook
  • Discovery Harbour
  • East Honolulu

Browse all communities in Hawaii

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

Show the CMS file lines behind this rate
RVUs for 43757PPRRVU2026_Oct_nonQPP.csv, line 5,288 (RVU26D)
Geographic factors for Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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