Billing code 43754: Gastric aspirationMedicare rate & RVUs in Illinois
Reports diagnostic gastric intubation with aspiration and collection of one specimen for analysis, rather than tube placement alone or therapeutic aspiration.
Medicare pays $313.50–$350.96 for 43754 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. Which amount applies depends on the service address.
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 9 sections
What 43754 covers
A clinician passes a tube into the stomach and aspirates gastric contents to obtain one specimen for diagnostic analysis. The service may be performed in a hospital or another setting where gastric sampling is clinically indicated. It is distinct from placing a gastric tube without diagnostic aspiration and from using intubation and aspiration for treatment.
Report this code when the documented service includes diagnostic gastric aspiration and collection of a single specimen. Documentation should identify the gastric sampling and the specimen collected; when multiple specimens are obtained, the corresponding multiple-specimen code is the relevant comparison. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for this service. Assistant-at-surgery services may be paid; 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.
Where 43754 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$313.50 to $350.96
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $345.82 | $52.77 |
| East St. Louis | $317.40 | $49.14 |
| Rest Of Illinois | $313.50 | $47.27 |
| Suburban Chicago | $350.96 | $51.50 |
How the 43754 rate is calculated
Each of 43754’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 · 43754
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.44Practice expense 9.61Malpractice 0.11
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 43754
The CMS indicators that decide how 43754 is paid alongside other services.
CMS payment indicators · 43754
Gastric aspiration
| 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 | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| 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 80 · payment effect
With and without the modifier
43754 without 80 · national office
$339.35
Gastric aspiration
43754-80 · Assistant: 16%
$54.30
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
43754 compared with similar codes
Compare codes
43754 vs 43755 vs 43752 vs 43753 vs 43756: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43755Gastric aspiration
- Both describe diagnostic gastric sampling; choose 43754 for one specimen and 43755 when multiple specimens are collected.
- 43752Gastric tube placement
- 43752 represents gastric tube placement. This code requires diagnostic aspiration and collection of a gastric specimen.
- 43753Gastric aspiration
- 43753 is therapeutic gastric intubation and aspiration; this code is for diagnostic sampling of one specimen.
- 43756Duodenal aspiration
- 43756 is diagnostic sampling from the duodenum. This code is for a single gastric specimen.
43754 billing questions
When should this code be chosen over 43755?
Use this code for diagnostic gastric aspiration with one specimen. Code 43755 is the multiple-specimen counterpart.
Is gastric tube placement by itself enough to report this code?
No. The service includes diagnostic aspiration and collection of a specimen; tube placement alone is represented by 43752.
How does this differ from 43753?
This code describes diagnostic sampling of one gastric specimen. Code 43753 is for therapeutic gastric intubation and aspiration.
Can modifier 50 be used for aspiration from both sides?
No. Bilateral adjustment is inappropriate for this gastric procedure.
What same-day care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant or another surgeon be reported?
CMS permits payment for an assistant at surgery. 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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