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CMS RVU26D · Effective 2026-10-01

43756 in Delaware

Office / nonfacility

$299.86

Base rate per service

Facility setting

$46.75

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Gastrointestinal procedure

About 43756: Diagnostic duodenal intubation with aspiration

Reports diagnostic passage of a tube into the duodenum to aspirate one specimen of duodenal contents for laboratory evaluation.

A clinician passes an intubation tube into the duodenum and aspirates duodenal contents for diagnostic testing. The service may be performed when a specimen of duodenal fluid is needed for laboratory evaluation; it is distinct from collecting gastric contents or placing a tube for therapeutic use. The code is for one specimen, making specimen count a key distinction from its duodenal sibling code.

Report the service when documentation supports diagnostic duodenal intubation and aspiration of a single specimen. The record should identify the duodenal site, the diagnostic purpose, and the specimen obtained. 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.

CMS billing rules for 43756

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU0.75 · 8%
  • Practice expense (office) RVU8.26 · 91%
  • Malpractice RVU0.07 · 1%

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.

43756 compared with similar codes

Office rates for Delaware, from the same CMS release.

43757

Duodenal aspiration

Multiple specimens

$403.21

Both codes describe diagnostic duodenal intubation with aspiration. Choose 43756 for one specimen and 43757 when multiple specimens are obtained.

43754

Gastric aspiration

Single specimen

$335.20

43754 is for diagnostic aspiration of a gastric specimen; 43756 is for a duodenal specimen.

43755

Gastric aspiration

Multiple diagnostic specimens

$222.02

43755 covers multiple diagnostic gastric specimens. 43756 concerns a single specimen from the duodenum.

43753

Gastric aspiration

Therapeutic decompression

No office rate

43753 describes therapeutic gastric intubation with aspiration. 43756 is diagnostic sampling from the duodenum.

The same code, a different location

How does Delaware compare?

43756 across payment areas

Same release and payment basis · bars start at $0

  1. Delaware · This locality

    $299.86

  2. $54.15 higher than Delaware

  3. $54.15 higher than Delaware

  4. Miami

    $318.17

    $18.31 higher than Delaware

  5. Chicago

    $307.86

    $8.00 higher than Delaware

  6. Manhattan

    $350.95

    $51.09 higher than Delaware

  7. Alaska*

    $332.69

    $32.83 higher than Delaware

Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 43756 ranges from $263.25 in Arkansas to $426.89 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas
  • Alabama

    Alabama · 43756

    Office

    $267.78

    Facility

    $43.62

    $32.08 lower than Delaware for the office setting.

  • Arkansas

    Arkansas · 43756

    Office

    $263.25

    Facility

    $43.18

    $36.61 lower than Delaware for the office setting.

  • Arizona

    Arizona · 43756

    Office

    $294.39

    Facility

    $46.15

    $5.47 lower than Delaware for the office setting.

  • Bakersfield

    California · 43756

    Office

    $329.33

    Facility

    $48.55

    $29.47 higher than Delaware for the office setting.

  • Chico

    California · 43756

    Office

    $329.11

    Facility

    $48.33

    $29.25 higher than Delaware for the office setting.

  • El Centro

    California · 43756

    Office

    $329.12

    Facility

    $48.34

    $29.26 higher than Delaware for the office setting.

  • Fresno

    California · 43756

    Office

    $329.11

    Facility

    $48.33

    $29.25 higher than Delaware for the office setting.

  • Hanford-Corcoran

    California · 43756

    Office

    $329.11

    Facility

    $48.33

    $29.25 higher than Delaware for the office setting.

  • Madera

    California · 43756

    Office

    $329.11

    Facility

    $48.33

    $29.25 higher than Delaware for the office setting.

  • Merced

    California · 43756

    Office

    $329.11

    Facility

    $48.33

    $29.25 higher than Delaware for the office setting.

  • Modesto

    California · 43756

    Office

    $329.11

    Facility

    $48.33

    $29.25 higher than Delaware for the office setting.

  • Napa

    California · 43756

    Office

    $391.44

    Facility

    $53.79

    $91.58 higher than Delaware for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 43756

    Office

    $353.31

    Facility

    $50.50

    $53.45 higher than Delaware for the office setting.

  • Redding

    California · 43756

    Office

    $329.11

    Facility

    $48.33

    $29.25 higher than Delaware for the office setting.

  • Rest Of California

    California · 43756

    Office

    $329.11

    Facility

    $48.33

    $29.25 higher than Delaware for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 43756

    Office

    $329.87

    Facility

    $49.09

    $30.01 higher than Delaware for the office setting.

  • Sacramento-Roseville-Folsom

    California · 43756

    Office

    $348.07

    Facility

    $50.12

    $48.21 higher than Delaware for the office setting.

  • Salinas

    California · 43756

    Office

    $346.84

    Facility

    $49.92

    $46.98 higher than Delaware for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 43756

    Office

    $357.04

    Facility

    $50.64

    $57.18 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 43756

    Office

    $417.51

    Facility

    $56.29

    $117.65 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 43756

    Office

    $417.43

    Facility

    $56.21

    $117.57 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 43756

    Office

    $426.89

    Facility

    $57.48

    $127.03 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 43756

    Office

    $426.57

    Facility

    $57.15

    $126.71 higher than Delaware for the office setting.

  • San Luis Obispo-Paso Robles

    California · 43756

    Office

    $340.97

    Facility

    $49.18

    $41.11 higher than Delaware for the office setting.

  • Santa Cruz-Watsonville

    California · 43756

    Office

    $362.04

    Facility

    $50.77

    $62.18 higher than Delaware for the office setting.

  • Santa Maria-Santa Barbara

    California · 43756

    Office

    $348.69

    Facility

    $49.98

    $48.83 higher than Delaware for the office setting.

  • Santa Rosa-Petaluma

    California · 43756

    Office

    $365.85

    Facility

    $51.26

    $65.99 higher than Delaware for the office setting.

  • Stockton

    California · 43756

    Office

    $329.11

    Facility

    $48.33

    $29.25 higher than Delaware for the office setting.

  • Vallejo

    California · 43756

    Office

    $391.33

    Facility

    $53.68

    $91.47 higher than Delaware for the office setting.

  • Visalia

    California · 43756

    Office

    $329.11

    Facility

    $48.33

    $29.25 higher than Delaware for the office setting.

  • Yuba City

    California · 43756

    Office

    $329.11

    Facility

    $48.33

    $29.25 higher than Delaware for the office setting.

  • Colorado

    Colorado · 43756

    Office

    $320.73

    Facility

    $48.15

    $20.87 higher than Delaware for the office setting.

  • Connecticut

    Connecticut · 43756

    Office

    $325.52

    Facility

    $49.60

    $25.66 higher than Delaware for the office setting.

  • Fort Lauderdale

    Florida · 43756

    Office

    $308.76

    Facility

    $49.24

    $8.90 higher than Delaware for the office setting.

  • Rest Of Florida

    Florida · 43756

    Office

    $292.32

    Facility

    $47.40

    $7.54 lower than Delaware for the office setting.

  • Atlanta

    Georgia · 43756

    Office

    $308.24

    Facility

    $47.96

    $8.38 higher than Delaware for the office setting.

  • Rest Of Georgia

    Georgia · 43756

    Office

    $273.93

    Facility

    $45.42

    $25.93 lower than Delaware for the office setting.

  • Hawaii, Guam

    Hawaii · 43756

    Office

    $340.09

    Facility

    $48.81

    $40.23 higher than Delaware for the office setting.

  • Iowa

    Iowa · 43756

    Office

    $278.42

    Facility

    $44.01

    $21.44 lower than Delaware for the office setting.

  • Idaho

    Idaho · 43756

    Office

    $279.98

    Facility

    $44.29

    $19.88 lower than Delaware for the office setting.

  • East St. Louis

    Illinois · 43756

    Office

    $283.58

    Facility

    $47.89

    $16.28 lower than Delaware for the office setting.

  • Rest Of Illinois

    Illinois · 43756

    Office

    $280.59

    Facility

    $46.70

    $19.27 lower than Delaware for the office setting.

  • Suburban Chicago

    Illinois · 43756

    Office

    $312.71

    Facility

    $49.61

    $12.85 higher than Delaware for the office setting.

  • Indiana

    Indiana · 43756

    Office

    $281.94

    Facility

    $44.45

    $17.92 lower than Delaware for the office setting.

  • Kansas

    Kansas · 43756

    Office

    $275.63

    Facility

    $44.04

    $24.23 lower than Delaware for the office setting.

  • Kentucky

    Kentucky · 43756

    Office

    $272.46

    Facility

    $44.71

    $27.40 lower than Delaware for the office setting.

  • New Orleans

    Louisiana · 43756

    Office

    $287.32

    Facility

    $46.25

    $12.54 lower than Delaware for the office setting.

  • Rest Of Louisiana

    Louisiana · 43756

    Office

    $271.45

    Facility

    $44.73

    $28.41 lower than Delaware for the office setting.

  • Metropolitan Boston

    Massachusetts · 43756

    Office

    $357.57

    Facility

    $51.69

    $57.71 higher than Delaware for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 43756

    Office

    $317.83

    Facility

    $48.07

    $17.97 higher than Delaware for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 43756

    Office

    $324.38

    Facility

    $49.49

    $24.52 higher than Delaware for the office setting.

  • Rest Of Maryland

    Maryland · 43756

    Office

    $306.65

    Facility

    $47.39

    $6.79 higher than Delaware for the office setting.

  • Rest Of Maine

    Maine · 43756

    Office

    $280.33

    Facility

    $44.63

    $19.53 lower than Delaware for the office setting.

  • Southern Maine

    Maine · 43756

    Office

    $299.93

    Facility

    $46.06

    $0.07 higher than Delaware for the office setting.

  • Detroit

    Michigan · 43756

    Office

    $295.23

    Facility

    $48.01

    $4.63 lower than Delaware for the office setting.

  • Rest Of Michigan

    Michigan · 43756

    Office

    $279.58

    Facility

    $45.68

    $20.28 lower than Delaware for the office setting.

  • Minnesota

    Minnesota · 43756

    Office

    $309.64

    Facility

    $46.02

    $9.78 higher than Delaware for the office setting.

  • Metropolitan Kansas City

    Missouri · 43756

    Office

    $286.40

    Facility

    $45.84

    $13.46 lower than Delaware for the office setting.

  • Metropolitan St. Louis

    Missouri · 43756

    Office

    $290.04

    Facility

    $46.15

    $9.82 lower than Delaware for the office setting.

  • Rest Of Missouri

    Missouri · 43756

    Office

    $265.15

    Facility

    $44.31

    $34.71 lower than Delaware for the office setting.

  • Mississippi

    Mississippi · 43756

    Office

    $264.32

    Facility

    $43.75

    $35.54 lower than Delaware for the office setting.

  • Montana**

    Montana · 43756

    Office

    $303.28

    Facility

    $47.09

    $3.42 higher than Delaware for the office setting.

  • North Carolina

    North Carolina · 43756

    Office

    $283.95

    Facility

    $44.93

    $15.91 lower than Delaware for the office setting.

  • North Dakota**

    North Dakota · 43756

    Office

    $301.89

    Facility

    $45.71

    $2.03 higher than Delaware for the office setting.

  • Nebraska

    Nebraska · 43756

    Office

    $280.58

    Facility

    $44.12

    $19.28 lower than Delaware for the office setting.

  • New Hampshire

    New Hampshire · 43756

    Office

    $314.30

    Facility

    $47.61

    $14.44 higher than Delaware for the office setting.

  • Northern Nj

    New Jersey · 43756

    Office

    $349.16

    Facility

    $51.99

    $49.30 higher than Delaware for the office setting.

  • Rest Of New Jersey

    New Jersey · 43756

    Office

    $329.89

    Facility

    $50.14

    $30.03 higher than Delaware for the office setting.

  • New Mexico

    New Mexico · 43756

    Office

    $280.85

    Facility

    $45.93

    $19.01 lower than Delaware for the office setting.

  • Nevada**

    Nevada · 43756

    Office

    $303.17

    Facility

    $46.72

    $3.31 higher than Delaware for the office setting.

  • Nyc Suburbs/Long Island

    New York · 43756

    Office

    $359.03

    Facility

    $54.43

    $59.17 higher than Delaware for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 43756

    Office

    $331.11

    Facility

    $50.59

    $31.25 higher than Delaware for the office setting.

  • Queens

    New York · 43756

    Office

    $356.13

    Facility

    $53.32

    $56.27 higher than Delaware for the office setting.

  • Rest Of New York

    New York · 43756

    Office

    $288.79

    Facility

    $45.42

    $11.07 lower than Delaware for the office setting.

  • Ohio

    Ohio · 43756

    Office

    $279.30

    Facility

    $45.40

    $20.56 lower than Delaware for the office setting.

  • Oklahoma

    Oklahoma · 43756

    Office

    $273.24

    Facility

    $44.47

    $26.62 lower than Delaware for the office setting.

  • Portland

    Oregon · 43756

    Office

    $333.71

    Facility

    $49.08

    $33.85 higher than Delaware for the office setting.

  • Rest Of Oregon

    Oregon · 43756

    Office

    $301.48

    Facility

    $46.32

    $1.62 higher than Delaware for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 43756

    Office

    $315.49

    Facility

    $48.81

    $15.63 higher than Delaware for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 43756

    Office

    $280.53

    Facility

    $45.35

    $19.33 lower than Delaware for the office setting.

  • Puerto Rico

    Puerto Rico · 43756

    Office

    $306.28

    Facility

    $47.28

    $6.42 higher than Delaware for the office setting.

  • Rhode Island

    Rhode Island · 43756

    Office

    $312.61

    Facility

    $47.97

    $12.75 higher than Delaware for the office setting.

  • South Carolina

    South Carolina · 43756

    Office

    $281.96

    Facility

    $45.25

    $17.90 lower than Delaware for the office setting.

  • South Dakota**

    South Dakota · 43756

    Office

    $301.73

    Facility

    $45.54

    $1.87 higher than Delaware for the office setting.

  • Tennessee

    Tennessee · 43756

    Office

    $277.09

    Facility

    $44.22

    $22.77 lower than Delaware for the office setting.

  • Austin

    Texas · 43756

    Office

    $319.07

    Facility

    $48.02

    $19.21 higher than Delaware for the office setting.

  • Beaumont

    Texas · 43756

    Office

    $278.28

    Facility

    $45.16

    $21.58 lower than Delaware for the office setting.

  • Brazoria

    Texas · 43756

    Office

    $300.48

    Facility

    $46.60

    $0.62 higher than Delaware for the office setting.

  • Dallas

    Texas · 43756

    Office

    $302.07

    Facility

    $46.91

    $2.21 higher than Delaware for the office setting.

  • Fort Worth

    Texas · 43756

    Office

    $299.34

    Facility

    $46.74

    $0.52 lower than Delaware for the office setting.

  • Galveston

    Texas · 43756

    Office

    $301.15

    Facility

    $46.76

    $1.29 higher than Delaware for the office setting.

  • Houston

    Texas · 43756

    Office

    $302.43

    Facility

    $48.04

    $2.57 higher than Delaware for the office setting.

  • Rest Of Texas

    Texas · 43756

    Office

    $288.98

    Facility

    $45.86

    $10.88 lower than Delaware for the office setting.

  • Utah

    Utah · 43756

    Office

    $286.49

    Facility

    $45.67

    $13.37 lower than Delaware for the office setting.

  • Virginia

    Virginia · 43756

    Office

    $297.90

    Facility

    $46.07

    $1.96 lower than Delaware for the office setting.

  • Virgin Islands

    United States Virgin Islands · 43756

    Office

    $306.28

    Facility

    $47.28

    $6.42 higher than Delaware for the office setting.

  • Vermont

    Vermont · 43756

    Office

    $299.37

    Facility

    $45.74

    $0.49 lower than Delaware for the office setting.

  • Rest Of Washington

    Washington · 43756

    Office

    $317.67

    Facility

    $47.91

    $17.81 higher than Delaware for the office setting.

  • Seattle (King Cnty)

    Washington · 43756

    Office

    $366.73

    Facility

    $52.39

    $66.87 higher than Delaware for the office setting.

  • Wisconsin

    Wisconsin · 43756

    Office

    $290.07

    Facility

    $44.65

    $9.79 lower than Delaware for the office setting.

  • West Virginia

    West Virginia · 43756

    Office

    $268.15

    Facility

    $45.52

    $31.71 lower than Delaware for the office setting.

  • Wyoming**

    Wyoming · 43756

    Office

    $302.67

    Facility

    $46.49

    $2.81 higher than Delaware for the office setting.

See how rates vary across the country

43756 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$263.25

$378.00

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$332.691
AL$267.781
AR$263.251
AZ$294.391
CA$329.11–$426.8929
CO$320.731
CT$325.521
DC$354.011
DE$299.861
FL$292.32–$318.173
GA$273.93–$308.242
GU$340.091
HI$340.091
IA$278.421
ID$279.981
IL$280.59–$312.714
IN$281.941
KS$275.631
KY$272.461
LA$271.45–$287.322
MA$317.83–$357.572
MD$306.65–$354.013
ME$280.33–$299.932
MI$279.58–$295.232
MN$309.641
MO$265.15–$290.043
MS$264.321
MT$303.281
NC$283.951
ND$301.891
NE$280.581
NH$314.301
NJ$329.89–$349.162
NM$280.851
NV$303.171
NY$288.79–$359.035
OH$279.301
OK$273.241
OR$301.48–$333.712
PA$280.53–$315.492
PR$306.281
RI$312.611
SC$281.961
SD$301.731
TN$277.091
TX$278.28–$319.078
UT$286.491
VA$297.90–$354.012
VI$306.281
VT$299.371
WA$317.67–$366.732
WI$290.071
WV$268.151
WY$302.671

Explore 43756 on the national rate map →

Where does this rate apply?

Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Why are the office and facility amounts different?

For 43756 in Delaware, the physician’s office rate is $299.86 and the facility-setting rate is $46.75: a difference of $253.11.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 43756 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$329.85

$299.86 × 110% = $329.85

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 43756 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

5,287

Code
43756
Physician work
0.75
Practice expense
8.26
Malpractice
0.07

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office / nonfacility calculation for 43756 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.75× 1.0050.7537
Practice expense8.26× 0.9888.1609
Malpractice0.07× 0.8990.0629
Total RVUs8.9776
Conversion factor× 33.4009

Office / nonfacility rate, Delaware$299.86

Open 43756 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.751.005
Practice expense8.260.988
Malpractice0.070.899

(0.75 × 1.005 + 8.26 × 0.988 + 0.07 × 0.899) × $33.4009 = $299.86

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.751.005
Practice expense0.590.988
Malpractice0.070.899

(0.75 × 1.005 + 0.59 × 0.988 + 0.07 × 0.899) × $33.4009 = $46.75

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

43756 · Office / nonfacility

$299.86

Effective 2026-10-01

The base rate is $45.41 higher than on 2025-10-01, moving from $254.45 to $299.86 (17.8%).

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

    $254.45changed to$299.86

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.77 changed to 0.75
    • Practice expense RVU 7.07 changed to 8.26
    • Malpractice RVU 0.08 changed to 0.07
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $254.45

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$299.86$46.75RVU26D
2026-07-01$299.86$46.75RVU26C
2026-04-01$299.86$46.75RVU26B
2026-01-01$299.86$46.75RVU26A
2025-10-01$254.45$48.76RVU25D
2025-07-01$254.45$48.76RVU25C
2025-04-01$254.45$48.76RVU25B
2025-01-01$254.45$48.76RVU25A

43756 billing questions

When should 43756 be chosen over 43757?

Use 43756 for aspiration of one diagnostic duodenal specimen. The related 43757 code is for multiple specimens.

How does this differ from gastric intubation codes?

43756 involves diagnostic intubation and aspiration in the duodenum. Codes 43754 and 43755 concern gastric specimens, with the specimen count distinguishing those codes.

Can tube placement be billed separately?

The intubation and aspiration are part of this diagnostic service. Do not separately report a tube-placement service for the same intubation.

What documentation supports reporting 43756?

Document that the tube reached the duodenum, that aspiration was performed for diagnostic evaluation, and that one specimen was obtained.

Can modifier 50 be used, or can co-surgeons be reported?

Modifier 50 is inappropriate for this service. CMS does not permit co-surgeons or team surgery; an assistant at surgery may be paid.

What care is included in the global period?

The service has a 0-day global period, which includes same-day preoperative and postoperative care.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 43756PPRRVU2026_Oct_nonQPP.csv, line 5,287 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)