CPT code 43763: G-tube replacement, with gastrostomy tract revision2026 Medicare rate & RVUs in Ohio

Report this service when a gastrostomy tube is replaced through an existing opening and the tract must also be revised.

CMS RVU26DEffective Oct 1, 2026One payment locality2.3K Medicare services in 2024

In Ohio, Medicare pays $344.89 for 43763 in the office and $80.80 when it’s performed in a hospital or facility.

$344.89Office (non-facility)
$80.80Hospital or facility
−7.4%vs the national office rate ($372.42)

Check a contract rate as a % of Medicare · 43763 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 43763 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Ohio
  2. What 43763 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 43763 covers

This procedure replaces a gastrostomy feeding tube through an existing abdominal opening when the tract needs revision to accommodate the replacement. A narrowed tract that prevents a straightforward tube exchange is a typical reason for the additional work. The treating physician may perform the procedure in an office or facility setting. The service includes removal of the old tube when removal is necessary.

Select 43763 based on documented revision of the gastrostomy tract, not simply difficulty removing or reinserting the tube. If the existing tract permits replacement without revision, 43762 describes the simpler exchange. Tube removal performed as part of the replacement is included. Medicare assigns this minor procedure a 0-day global period, which includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Modifier 50 is inappropriate for this anatomy. Medicare does not pay an assistant at surgery for 43763; 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 Ohio compares for 43763

Across 109 of 109 payment localities, the office rate for 43763 runs from $323.14 in Arkansas to $513.36 in San Benito County, CA. Ohio pays $344.89. The RVUs are the same everywhere; the geographic indexes change the dollars.

43763 in Ohio vs other payment areas
  1. Ohio · this page$344.89
  2. Los Angeles, CA · California$429.22+$84.33
  3. Washington, DC area · District of Columbia$432.43+$87.54
  4. Miami, FL · Florida$399.73+$54.84
  5. Chicago, IL · Illinois$386.44+$41.55
  6. Manhattan, NY · New York$432.23+$87.34
  7. Alaska · Alaska$411.73+$66.84

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

Every other payment area

43763 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$328.70$75.60
ArkansasArkansas$323.14$74.68
ArizonaArizona$361.24$80.95
Bakersfield, CACalifornia$400.09$83.07
Chico, CACalifornia$399.32$82.30
El Centro, CACalifornia$399.37$82.35
Fresno, CACalifornia$399.32$82.30
Hanford, CACalifornia$399.32$82.30

43763 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.

$323.14

$456.34

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

View every state and territory as a table
43763 office rate range by state
State / territoryOffice rate rangeLocalities
AK$411.731
AL$328.701
AR$323.141
AZ$361.241
CA$399.32–$513.3629
CO$391.231
CT$399.731
DC$432.431
DE$367.901
FL$363.16–$399.733
GA$339.95–$379.512
GU$411.951
HI$411.951
IA$339.811
ID$342.111
IL$350.08–$388.534
IN$344.451
KS$337.321
KY$336.401
LA$335.54–$354.972
MA$388.07–$434.832
MD$375.92–$432.433
ME$343.50–$366.112
MI$346.02–$367.732
MN$375.041
MO$328.39–$357.213
MS$325.871
MT$372.401
NC$347.781
ND$366.861
NE$342.171
NH$384.261
NJ$404.35–$426.712
NM$347.961
NV$371.181
NY$353.78–$443.335
OH$344.891
OK$336.381
OR$368.37–$405.982
PA$345.89–$388.062
PR$375.771
RI$382.751
SC$346.901
SD$366.211
TN$339.211
TX$343.20–$389.858
UT$352.431
VA$364.28–$432.432
VI$375.771
VT$364.631
WA$387.60–$445.032
WI$352.621
WV$334.881
WY$369.991

See 43763 in every payment locality

How the 43763 rate is calculated

Each of 43763’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 · 43763

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.37

1.37 RVUs× 1.000 GPCI

Practice expense9.50

9.50 RVUs× 1.000 GPCI

Malpractice0.28

0.28 RVUs× 1.000 GPCI

Adjusted RVUs

11.1500

Conversion factor

$33.4009

Medicare rate

$372.42

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

The exact Ohio inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,291

Code
43763
Physician work
1.37
Practice expense
9.50
Malpractice
0.28

GPCI2026.csv

85

Locality
Ohio
Physician work
1.000
Practice expense
0.913
Malpractice
1.008
Office calculation for 43763 in Ohio
ComponentRVULocality factorAdjusted
Physician work1.37× 1.0001.3700
Practice expense9.50× 0.9138.6735
Malpractice0.28× 1.0080.2822
Total RVUs10.3257
Conversion factor× 33.4009

Office rate, Ohio$344.89

Office: (1.37 × 1 + 9.5 × 0.913 + 0.28 × 1.008) × $33.4009 = $344.89

Facility: (1.37 × 1 + 0.84 × 0.913 + 0.28 × 1.008) × $33.4009 = $80.80

Open 43763 in the RVU calculator

Payment rules and modifiers for 43763

The CMS indicators that decide how 43763 is paid alongside other services.

CMS payment indicators · 43763

G-tube replacement, with gastrostomy 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

43763 without 51 · national office

$372.42

G-tube replacement, with gastrostomy tract revision

43763-51 · Second procedure: 50%

$186.21

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 43763 has changed in Ohio

43763 · Office / nonfacility

$344.89

Effective 2026-10-01

The base rate is $53.89 higher than on 2025-10-01, moving from $291.00 to $344.89 (18.5%).

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

    $291.00changed to$344.89

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.41 changed to 1.37
    • Practice expense RVU 8.01 changed to 9.50
    • Practice expense GPCI 0.911 changed to 0.913
    • Malpractice GPCI 1.033 changed to 1.008

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $308.52changed to$291.00

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.32 changed to 8.01
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $303.49changed to$308.52

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $319.58changed to$303.49

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.48 changed to 8.32
    • Practice expense GPCI 0.912 changed to 0.911
    • Malpractice GPCI 1.063 changed to 1.033
  5. January 1, 2023

    RVU23A

    $340.09changed to$319.58

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.92 changed to 8.48
    • Malpractice RVU 0.25 changed to 0.27
    • Practice expense GPCI 0.913 changed to 0.912
    • Malpractice GPCI 1.094 changed to 1.063

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $346.10changed to$340.09

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.02 changed to 8.92

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $323.87changed to$346.10

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.98 changed to 9.02
    • Practice expense GPCI 0.915 changed to 0.913
    • Malpractice GPCI 1.049 changed to 1.094

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $314.51changed to$323.87

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.76 changed to 7.98
    • Malpractice RVU 0.20 changed to 0.25
    • Practice expense GPCI 0.917 changed to 0.915
    • Malpractice GPCI 1.005 changed to 1.049

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$314.51

    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$344.89$80.80RVU26D
2026-07-01$344.89$80.80RVU26C
2026-04-01$344.89$80.80RVU26B
2026-01-01$344.89$80.80RVU26A
2025-10-01$291.00$82.66RVU25D
2025-07-01$291.00$82.66RVU25C
2025-04-01$291.00$82.66RVU25B
2025-01-01$291.00$82.66RVU25A
2024-10-01$308.52$84.42RVU24D
2024-07-01$308.52$84.42RVU24C
2024-04-01$308.52$84.42RVU24B
2024-03-09$308.52$84.42RVU24AR
2024-01-01$303.49$83.04RVU24A
2023-10-01$319.58$85.63RVU23D
2023-07-01$319.58$85.63RVU23C
2023-04-01$319.58$85.63RVU23B
2023-01-01$319.58$85.63RVU23A
2022-10-01$340.09$84.80RVU22D
2022-07-01$340.09$84.80RVU22C
2022-04-01$340.09$84.80RVU22B
2022-01-01$340.09$84.80RVU22A
2021-10-01$346.10$84.55RVU21D
2021-07-01$346.10$84.55RVU21C
2021-04-01$346.10$84.55RVU21B
2021-01-01$346.10$84.55RVU21A
2020-10-01$323.87$86.11RVU20D
2020-07-01$323.87$86.11RVU20C
2020-04-01$323.87$86.11RVU20B
2020-01-01$323.87$86.11RVU20A
2019-10-01$314.51$84.50RVU19D
2019-07-01$314.51$84.50RVU19C
2019-04-01$314.51$84.50RVU19B
2019-01-01$314.51$84.50RVU19A
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 43763 for an earlier date of service

Where the Ohio rate applies

Ohio is a Medicare payment area, not a city. Our Census mapping connects it to 1265 cities and communities in Ohio. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Ada
  • Adamsville
  • Addyston
  • Adelphi
  • Adena
  • Ai
  • Akron

Browse all communities in Ohio

43763 billing questions

When should 43763 be chosen instead of 43762?

Choose 43763 when the replacement requires revision of the existing gastrostomy tract. Use 43762 for a tube replacement performed without tract revision.

Can removal of the old gastrostomy tube be billed separately?

No. Removal, when performed as part of this replacement, is included in 43763.

Does a difficult tube exchange qualify as tract revision?

Difficulty alone does not establish tract revision. The procedure record should describe the work performed on the tract to permit replacement.

How does Medicare handle 43763 when another procedure is performed in the same session?

The standard multiple-procedure reduction applies: the highest-valued procedure is paid in full, and other procedures are paid at 50%. Same-day preoperative and postoperative care is included in the 0-day global period.

Can modifier 50 or a surgical team arrangement be reported for 43763?

Modifier 50 is inappropriate for a gastrostomy tract. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

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 43763PPRRVU2026_Oct_nonQPP.csv, line 5,291 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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