CPT code 43763: G-tube replacement, with gastrostomy tract revision2026 Medicare rate & RVUs in Puerto Rico
Report this service when a gastrostomy tube is replaced through an existing opening and the tract must also be revised.
In Puerto Rico, Medicare pays $375.77 for 43763 in the office and $83.34 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Puerto Rico 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. Puerto Rico pays $375.77. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$375.77
- Los Angeles, CA · California$429.22+$53.45
- Washington, DC area · District of Columbia$432.43+$56.66
- Miami, FL · Florida$399.73+$23.96
- Chicago, IL · Illinois$386.44+$10.67
- Manhattan, NY · New York$432.23+$56.46
- Alaska · Alaska$411.73+$35.96
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $399.32 | $82.30 |
| Merced, CACalifornia | $399.32 | $82.30 |
| Modesto, CACalifornia | $399.32 | $82.30 |
| Napa, CACalifornia | $471.61 | $90.37 |
| Oxnard, CACalifornia | $427.93 | $86.03 |
| Redding, CACalifornia | $399.32 | $82.30 |
| Rest of CaliforniaCalifornia | $399.32 | $82.30 |
| Riverside, CACalifornia | $402.33 | $85.31 |
| Sacramento, CACalifornia | $421.45 | $85.05 |
| Salinas, CACalifornia | $419.95 | $84.71 |
| San Diego, CACalifornia | $431.70 | $85.76 |
| Marin County, CACalifornia | $501.80 | $93.96 |
| San Francisco, CACalifornia | $501.49 | $93.64 |
| San Benito County, CACalifornia | $513.36 | $96.26 |
| Santa Clara County, CACalifornia | $512.06 | $94.96 |
| San Luis Obispo, CACalifornia | $412.96 | $83.51 |
| Santa Cruz, CACalifornia | $437.26 | $85.82 |
| Santa Maria, CACalifornia | $422.04 | $84.77 |
| Santa Rosa, CACalifornia | $441.80 | $86.60 |
| Stockton, CACalifornia | $399.32 | $82.30 |
| Vallejo, CACalifornia | $471.15 | $89.91 |
| Visalia, CACalifornia | $399.32 | $82.30 |
| Yuba City, CACalifornia | $399.32 | $82.30 |
| ColoradoColorado | $391.23 | $83.46 |
| ConnecticutConnecticut | $399.73 | $88.21 |
| DelawareDelaware | $367.90 | $82.12 |
| Fort Lauderdale, FLFlorida | $384.10 | $91.09 |
| Rest of FloridaFlorida | $363.16 | $86.64 |
| Atlanta, GAGeorgia | $379.51 | $85.63 |
| Rest of GeorgiaGeorgia | $339.95 | $81.93 |
| Hawaii, Guam, HIHawaii | $411.95 | $83.07 |
| IowaIowa | $339.81 | $75.14 |
| IdahoIdaho | $342.11 | $76.00 |
| East St. Louis, ILIllinois | $356.52 | $90.41 |
| Rest of IllinoisIllinois | $350.08 | $85.99 |
| Suburban Chicago, ILIllinois | $388.53 | $91.47 |
| IndianaIndiana | $344.45 | $76.31 |
| KansasKansas | $337.32 | $75.84 |
| KentuckyKentucky | $336.40 | $79.26 |
| New Orleans, LALouisiana | $354.97 | $82.78 |
| Rest of LouisianaLouisiana | $335.54 | $79.55 |
| Metropolitan Boston, MAMassachusetts | $434.83 | $89.46 |
| Rest of MassachusettsMassachusetts | $388.07 | $83.49 |
| Baltimore area, MDMaryland | $398.53 | $88.17 |
| Rest of MarylandMaryland | $375.92 | $83.20 |
| Rest of MaineMaine | $343.50 | $77.39 |
| Southern Maine, MEMaine | $366.11 | $79.46 |
| Detroit, MIMichigan | $367.73 | $88.60 |
| Rest of MichiganMichigan | $346.02 | $81.93 |
| MinnesotaMinnesota | $375.04 | $77.40 |
| Metropolitan Kansas City, MOMissouri | $352.85 | $81.24 |
| Metropolitan St. Louis, MOMissouri | $357.21 | $81.84 |
| Rest of MissouriMissouri | $328.39 | $79.05 |
| MississippiMississippi | $325.87 | $76.83 |
| MontanaMontana | $372.40 | $83.15 |
| North CarolinaNorth Carolina | $347.78 | $77.91 |
| North DakotaNorth Dakota | $366.86 | $77.61 |
| NebraskaNebraska | $342.17 | $75.19 |
| New HampshireNew Hampshire | $384.26 | $83.15 |
| Northern New JerseyNew Jersey | $426.71 | $91.18 |
| Rest of New JerseyNew Jersey | $404.35 | $88.49 |
| New MexicoNew Mexico | $347.96 | $82.72 |
| NevadaNevada | $371.18 | $81.63 |
| NYC suburbs and Long Island, NYNew York | $443.33 | $99.41 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $406.59 | $89.86 |
| Queens, NYNew York | $437.23 | $95.34 |
| Rest of New YorkNew York | $353.78 | $78.99 |
| OhioOhio | $344.89 | $80.80 |
| OklahomaOklahoma | $336.38 | $78.08 |
| Portland, OROregon | $405.98 | $84.62 |
| Rest of OregonOregon | $368.37 | $80.28 |
| Metropolitan Philadelphia, PAPennsylvania | $388.06 | $86.95 |
| Rest of PennsylvaniaPennsylvania | $345.89 | $80.35 |
| Rhode IslandRhode Island | $382.75 | $83.95 |
| South CarolinaSouth Carolina | $346.90 | $79.63 |
| South DakotaSouth Dakota | $366.21 | $76.96 |
| TennesseeTennessee | $339.21 | $76.28 |
| Austin, TXTexas | $389.85 | $83.82 |
| Beaumont, TXTexas | $343.20 | $79.98 |
| Brazoria, TXTexas | $367.87 | $81.22 |
| Dallas, TXTexas | $370.23 | $82.14 |
| Fort Worth, TXTexas | $367.18 | $81.98 |
| Galveston, TXTexas | $368.96 | $81.73 |
| Houston, TXTexas | $374.08 | $86.85 |
| Rest of TexasTexas | $355.33 | $80.83 |
| UtahUtah | $352.43 | $80.53 |
| VirginiaVirginia | $364.28 | $79.94 |
| Virgin Islands, VIUnited States Virgin Islands | $375.77 | $83.34 |
| VermontVermont | $364.63 | $78.27 |
| Rest of WashingtonWashington | $387.60 | $83.01 |
| King County, WAWashington | $445.03 | $90.11 |
| WisconsinWisconsin | $352.62 | $75.52 |
| West VirginiaWest Virginia | $334.88 | $83.52 |
| WyomingWyoming | $369.99 | $80.74 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $411.73 | 1 |
| AL | $328.70 | 1 |
| AR | $323.14 | 1 |
| AZ | $361.24 | 1 |
| CA | $399.32–$513.36 | 29 |
| CO | $391.23 | 1 |
| CT | $399.73 | 1 |
| DC | $432.43 | 1 |
| DE | $367.90 | 1 |
| FL | $363.16–$399.73 | 3 |
| GA | $339.95–$379.51 | 2 |
| GU | $411.95 | 1 |
| HI | $411.95 | 1 |
| IA | $339.81 | 1 |
| ID | $342.11 | 1 |
| IL | $350.08–$388.53 | 4 |
| IN | $344.45 | 1 |
| KS | $337.32 | 1 |
| KY | $336.40 | 1 |
| LA | $335.54–$354.97 | 2 |
| MA | $388.07–$434.83 | 2 |
| MD | $375.92–$432.43 | 3 |
| ME | $343.50–$366.11 | 2 |
| MI | $346.02–$367.73 | 2 |
| MN | $375.04 | 1 |
| MO | $328.39–$357.21 | 3 |
| MS | $325.87 | 1 |
| MT | $372.40 | 1 |
| NC | $347.78 | 1 |
| ND | $366.86 | 1 |
| NE | $342.17 | 1 |
| NH | $384.26 | 1 |
| NJ | $404.35–$426.71 | 2 |
| NM | $347.96 | 1 |
| NV | $371.18 | 1 |
| NY | $353.78–$443.33 | 5 |
| OH | $344.89 | 1 |
| OK | $336.38 | 1 |
| OR | $368.37–$405.98 | 2 |
| PA | $345.89–$388.06 | 2 |
| PR | $375.77 | 1 |
| RI | $382.75 | 1 |
| SC | $346.90 | 1 |
| SD | $366.21 | 1 |
| TN | $339.21 | 1 |
| TX | $343.20–$389.85 | 8 |
| UT | $352.43 | 1 |
| VA | $364.28–$432.43 | 2 |
| VI | $375.77 | 1 |
| VT | $364.63 | 1 |
| WA | $387.60–$445.03 | 2 |
| WI | $352.62 | 1 |
| WV | $334.88 | 1 |
| WY | $369.99 | 1 |
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
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 Puerto Rico 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
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.37 | × 1.000 | 1.3700 |
| Practice expense | 9.50 | × 1.011 | 9.6045 |
| Malpractice | 0.28 | × 0.985 | 0.2758 |
| Total RVUs | 11.2503 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$375.77
Office: (1.37 × 1 + 9.5 × 1.011 + 0.28 × 0.985) × $33.4009 = $375.77
Facility: (1.37 × 1 + 0.84 × 1.011 + 0.28 × 0.985) × $33.4009 = $83.34
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
| 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 | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| 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 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%).
How 43763 has changed in Puerto Rico
43763 · Office / nonfacility
$375.77
Effective 2026-10-01
The base rate is $60.36 higher than on 2025-10-01, moving from $315.41 to $375.77 (19.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$315.41changed to$375.77
- 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 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$334.65changed to$315.41
- 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.
March 9, 2024
RVU24AR
$329.19changed to$334.65
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$346.45changed to$329.19
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.48 changed to 8.32
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$344.29changed to$346.45
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$368.48changed to$344.29
- 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 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$375.05changed to$368.48
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 9.02 changed to 8.92
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$350.10changed to$375.05
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 7.98 changed to 9.02
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$339.57changed to$350.10
- 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 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$339.57
Held through RVU19B, RVU19C, RVU19D.
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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $375.77 | $83.34 | RVU26D |
| 2026-07-01 | $375.77 | $83.34 | RVU26C |
| 2026-04-01 | $375.77 | $83.34 | RVU26B |
| 2026-01-01 | $375.77 | $83.34 | RVU26A |
| 2025-10-01 | $315.41 | $85.12 | RVU25D |
| 2025-07-01 | $315.41 | $85.12 | RVU25C |
| 2025-04-01 | $315.41 | $85.12 | RVU25B |
| 2025-01-01 | $315.41 | $85.12 | RVU25A |
| 2024-10-01 | $334.65 | $86.94 | RVU24D |
| 2024-07-01 | $334.65 | $86.94 | RVU24C |
| 2024-04-01 | $334.65 | $86.94 | RVU24B |
| 2024-03-09 | $334.65 | $86.94 | RVU24AR |
| 2024-01-01 | $329.19 | $85.52 | RVU24A |
| 2023-10-01 | $346.45 | $87.87 | RVU23D |
| 2023-07-01 | $344.29 | $87.77 | RVU23C |
| 2023-04-01 | $344.29 | $87.77 | RVU23B |
| 2023-01-01 | $344.29 | $87.77 | RVU23A |
| 2022-10-01 | $368.48 | $86.63 | RVU22D |
| 2022-07-01 | $368.48 | $86.63 | RVU22C |
| 2022-04-01 | $368.48 | $86.63 | RVU22B |
| 2022-01-01 | $368.48 | $86.63 | RVU22A |
| 2021-10-01 | $375.05 | $86.29 | RVU21D |
| 2021-07-01 | $375.05 | $86.29 | RVU21C |
| 2021-04-01 | $375.05 | $86.29 | RVU21B |
| 2021-01-01 | $375.05 | $86.29 | RVU21A |
| 2020-10-01 | $350.10 | $88.18 | RVU20D |
| 2020-07-01 | $350.10 | $88.18 | RVU20C |
| 2020-04-01 | $350.10 | $88.18 | RVU20B |
| 2020-01-01 | $350.10 | $88.18 | RVU20A |
| 2019-10-01 | $339.57 | $86.98 | RVU19D |
| 2019-07-01 | $339.57 | $86.98 | RVU19C |
| 2019-04-01 | $339.57 | $86.98 | RVU19B |
| 2019-01-01 | $339.57 | $86.98 | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
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
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