Billing code 43756: Duodenal aspirationMedicare rate & RVUs in Illinois
Reports diagnostic passage of a tube into the duodenum to aspirate one specimen of duodenal contents for laboratory evaluation.
Medicare pays $280.59–$312.71 for 43756 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 43756 covers
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.
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 43756 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
$280.59 to $312.71
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $307.86 | $50.40 |
| East St. Louis | $283.58 | $47.89 |
| Rest Of Illinois | $280.59 | $46.70 |
| Suburban Chicago | $312.71 | $49.61 |
How the 43756 rate is calculated
Each of 43756’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 · 43756
RVUs × geographic indexes × conversion factor
Work0.75
0.75 RVUs× 1.000 GPCI
Practice expense8.26
8.26 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
9.0800
Conversion factor
$33.4009
Medicare rate
$303.28
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43756
The CMS indicators that decide how 43756 is paid alongside other services.
CMS payment indicators · 43756
Duodenal 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
43756 without 80 · national office
$303.28
Duodenal aspiration
43756-80 · Assistant: 16%
$48.52
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
43756 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 43757Duodenal aspiration
- Both codes describe diagnostic duodenal intubation with aspiration. Choose 43756 for one specimen and 43757 when multiple specimens are obtained.
- 43754Gastric aspiration
- 43754 is for diagnostic aspiration of a gastric specimen; 43756 is for a duodenal specimen.
- 43755Gastric aspiration
- 43755 covers multiple diagnostic gastric specimens. 43756 concerns a single specimen from the duodenum.
- 43753Gastric aspiration
- 43753 describes therapeutic gastric intubation with aspiration. 43756 is diagnostic sampling from the duodenum.
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 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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