CPT code 43762: G-tube replacement, no tract revision2026 Medicare rate & RVUs in Utah

Reports percutaneous exchange of a gastrostomy tube through an established tract when the tract is not revised and imaging or endoscopic guidance is not used.

CMS RVU26DEffective Oct 1, 2026One payment locality45.1K Medicare services in 2024

In Utah, Medicare pays $257.14 for 43762 in the office and $33.59 when it’s performed in a hospital or facility.

$257.14Office (non-facility)
$33.59Hospital or facility
−5.5%vs the national office rate ($272.22)

Check a contract rate as a % of Medicare · 43762 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 43762 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 43762 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 43762 covers

This service covers replacing a gastrostomy tube through an established tract without revising that tract and without imaging or endoscopic guidance. It may be performed when a tube is damaged, clogged, or dislodged and needs exchange. Physicians and other qualified practitioners may perform the replacement in settings such as an office, hospital, or skilled nursing facility. Removal of the existing tube, when performed as part of the exchange, is included.

Report the code when documentation supports replacement through the existing tract and confirms that tract revision and imaging or endoscopic guidance were not required. A replacement requiring tract revision is distinguished from this service; fluoroscopic replacement is represented by a different code. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

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 Utah compares for 43762

Across 109 of 109 payment localities, the office rate for 43762 runs from $235.55 in Arkansas to $379.90 in San Benito County, CA. Utah pays $257.14. The RVUs are the same everywhere; the geographic indexes change the dollars.

43762 in Utah vs other payment areas
  1. Utah · this page$257.14
  2. Los Angeles, CA · California$315.97+$58.83
  3. Washington, DC area · District of Columbia$317.32+$60.18
  4. Miami, FL · Florida$289.83+$32.69
  5. Chicago, IL · Illinois$280.09+$22.95
  6. Manhattan, NY · New York$316.05+$58.91
  7. Alaska · Alaska$297.94+$40.80

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

Every other payment area

43762 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$239.69$31.60
ArkansasArkansas$235.55$31.27
ArizonaArizona$263.97$33.53
Bakersfield, CACalifornia$294.03$33.39
Chico, CACalifornia$293.62$32.97
El Centro, CACalifornia$293.64$33.00
Fresno, CACalifornia$293.62$32.97
Hanford, CACalifornia$293.62$32.97

43762 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.

$235.55

$336.76

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
43762 office rate range by state
State / territoryOffice rate rangeLocalities
AK$297.941
AL$239.691
AR$235.551
AZ$263.971
CA$293.62–$379.9029
CO$286.951
CT$292.451
DC$317.321
DE$268.921
FL$264.05–$289.833
GA$246.95–$277.182
GU$303.381
HI$303.381
IA$248.561
ID$250.151
IL$253.91–$282.814
IN$251.921
KS$246.421
KY$244.841
LA$244.08–$258.572
MA$284.46–$319.772
MD$274.96–$317.323
ME$250.90–$268.182
MI$251.74–$267.162
MN$275.731
MO$238.58–$260.573
MS$237.161
MT$272.211
NC$254.141
ND$269.241
NE$250.401
NH$281.551
NJ$296.02–$312.952
NM$253.071
NV$271.621
NY$258.59–$323.975
OH$251.131
OK$245.121
OR$269.76–$298.282
PA$252.03–$283.582
PR$274.811
RI$280.151
SC$253.011
SD$268.891
TN$247.801
TX$250.01–$285.788
UT$257.141
VA$266.62–$317.322
VI$274.811
VT$267.311
WA$284.21–$327.642
WI$258.551
WV$242.571
WY$270.911

See 43762 in every payment locality

How the 43762 rate is calculated

Each of 43762’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 · 43762

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.73

0.73 RVUs× 1.000 GPCI

Practice expense7.27

7.27 RVUs× 1.000 GPCI

Malpractice0.15

0.15 RVUs× 1.000 GPCI

Adjusted RVUs

8.1500

Conversion factor

$33.4009

Medicare rate

$272.22

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

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,290

Code
43762
Physician work
0.73
Practice expense
7.27
Malpractice
0.15

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 43762 in Utah
ComponentRVULocality factorAdjusted
Physician work0.73× 1.0000.7300
Practice expense7.27× 0.9406.8338
Malpractice0.15× 0.8980.1347
Total RVUs7.6985
Conversion factor× 33.4009

Office rate, Utah$257.14

Office: (0.73 × 1 + 7.27 × 0.94 + 0.15 × 0.898) × $33.4009 = $257.14

Facility: (0.73 × 1 + 0.15 × 0.94 + 0.15 × 0.898) × $33.4009 = $33.59

Open 43762 in the RVU calculator

Payment rules and modifiers for 43762

The CMS indicators that decide how 43762 is paid alongside other services.

CMS payment indicators · 43762

G-tube replacement, no tract revision

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

43762 without 51 · national office

$272.22

G-tube replacement, no tract revision

43762-51 · Second procedure: 50%

$136.11

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 43762 has changed in Utah

43762 · Office / nonfacility

$257.14

Effective 2026-10-01

The base rate is $57.25 higher than on 2025-10-01, moving from $199.89 to $257.14 (28.6%).

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

    $199.89changed to$257.14

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.75 changed to 0.73
    • Practice expense RVU 5.67 changed to 7.27
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $211.61changed to$199.89

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.87 changed to 5.67
    • Malpractice RVU 0.14 changed to 0.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $208.15changed to$211.61

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $216.58changed to$208.15

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.98 changed to 5.87
    • Malpractice RVU 0.12 changed to 0.14
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930
  5. January 1, 2023

    RVU23A

    $224.54changed to$216.58

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.14 changed to 5.98
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $229.57changed to$224.54

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.23 changed to 6.14
    • Malpractice RVU 0.13 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $217.19changed to$229.57

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.58 changed to 6.23
    • Malpractice RVU 0.12 changed to 0.13
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $213.72changed to$217.19

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.45 changed to 5.58
    • Malpractice RVU 0.11 changed to 0.12
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$213.72

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$257.14$33.59RVU26D
2026-07-01$257.14$33.59RVU26C
2026-04-01$257.14$33.59RVU26B
2026-01-01$257.14$33.59RVU26A
2025-10-01$199.89$35.41RVU25D
2025-07-01$199.89$35.41RVU25C
2025-04-01$199.89$35.41RVU25B
2025-01-01$199.89$35.41RVU25A
2024-10-01$211.61$36.13RVU24D
2024-07-01$211.61$36.13RVU24C
2024-04-01$211.61$36.13RVU24B
2024-03-09$211.61$36.13RVU24AR
2024-01-01$208.15$35.54RVU24A
2023-10-01$216.58$35.84RVU23D
2023-07-01$216.58$35.84RVU23C
2023-04-01$216.58$35.84RVU23B
2023-01-01$216.58$35.84RVU23A
2022-10-01$224.54$36.27RVU22D
2022-07-01$224.54$36.27RVU22C
2022-04-01$224.54$36.27RVU22B
2022-01-01$224.54$36.27RVU22A
2021-10-01$229.57$37.17RVU21D
2021-07-01$229.57$37.17RVU21C
2021-04-01$229.57$37.17RVU21B
2021-01-01$229.57$37.17RVU21A
2020-10-01$217.19$38.98RVU20D
2020-07-01$217.19$38.98RVU20C
2020-04-01$217.19$38.98RVU20B
2020-01-01$217.19$38.98RVU20A
2019-10-01$213.72$39.33RVU19D
2019-07-01$213.72$39.33RVU19C
2019-04-01$213.72$39.33RVU19B
2019-01-01$213.72$39.33RVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 43762 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

43762 billing questions

How does this differ from repositioning a gastrostomy tube?

Use 43762 when the tube is replaced through the established tract. Code 43761 describes repositioning the existing tube rather than exchanging it.

Is removal of the old tube separately reported?

No. Removal is included when performed as part of the replacement.

Can 43762 be used when the tract needs revision?

No. A replacement that requires revision of the gastrostomy tract is reported with 43763.

What if fluoroscopic guidance is used?

43762 describes replacement without imaging or endoscopic guidance. Fluoroscopic replacement is represented by 49450.

Can modifier 50 or an assistant-at-surgery modifier be used?

Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 43762PPRRVU2026_Oct_nonQPP.csv, line 5,290 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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