$118.81
43761 is for repositioning the existing tube. Choose 43762 when the tube itself is exchanged through the established tract.
On this page
CMS RVU26D · Effective 2026-10-01
43762 G-tube replacement Medicare reimbursement rates in Ohio
Reports percutaneous exchange of a gastrostomy tube through an established tract when the tract is not revised and imaging or endoscopic guidance is not used. Compare 43762 office and facility rates across CMS payment localities in Ohio.
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.
What does Medicare pay for 43762 in Ohio?
Ohio has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$251.13
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$34.01
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Gastroenterology procedure
About 43762: Percutaneous gastrostomy tube replacement
Reports percutaneous exchange of a gastrostomy tube through an established tract when the tract is not revised and imaging or endoscopic guidance is not used.
This service covers replacing a gastrostomy tube through an established tract without revising that tract and without imaging or endoscopic guidance. It may be performed when a tube is damaged, clogged, or dislodged and needs exchange. Physicians and other qualified practitioners may perform the replacement in settings such as an office, hospital, or skilled nursing facility. Removal of the existing tube, when performed as part of the exchange, is included.
Report the code when documentation supports replacement through the existing tract and confirms that tract revision and imaging or endoscopic guidance were not required. A replacement requiring tract revision is distinguished from this service; fluoroscopic replacement is represented by a different code. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 43762
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU0.73 · 9%
- Practice expense (office) RVU7.27 · 89%
- Malpractice RVU0.15 · 2%
45.1K
Medicare services in 2024 · #820 by national volume
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.
43762 compared with similar codes
Office rates for Ohio, from the same CMS release.
$344.89
Both codes report percutaneous tube replacement, but 43763 applies when the gastrostomy tract requires revision.
$519.40
Use 49450 for percutaneous gastrostomy tube replacement with imaging guidance; 43762 describes replacement without imaging or endoscopic guidance.
$732.18
49440 reports placement of a gastrostomy tube. Code 43762 is for replacing a tube through an existing tract.
Compare 43762 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Ohio →
Office / nonfacility
$251.13
Facility
$34.01
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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 43762 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
5,290
- Code
- 43762
- Physician work
- 0.73
- Practice expense
- 7.27
- Malpractice
- 0.15
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.73 | × 1.000 | 0.7300 |
| Practice expense | 7.27 | × 0.913 | 6.6375 |
| Malpractice | 0.15 | × 1.008 | 0.1512 |
| Total RVUs | 7.5187 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$251.13
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.73 | 1 |
| Practice expense | 7.27 | 0.913 |
| Malpractice | 0.15 | 1.008 |
(0.73 × 1 + 7.27 × 0.913 + 0.15 × 1.008) × $33.4009 = $251.13
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.73 | 1 |
| Practice expense | 0.15 | 0.913 |
| Malpractice | 0.15 | 1.008 |
(0.73 × 1 + 0.15 × 0.913 + 0.15 × 1.008) × $33.4009 = $34.01
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.
43762 billing questions
How does this differ from repositioning a gastrostomy tube?
Use 43762 when the tube is replaced through the established tract. Code 43761 describes repositioning the existing tube rather than exchanging it.
Is removal of the old tube separately reported?
No. Removal is included when performed as part of the replacement.
Can 43762 be used when the tract needs revision?
No. A replacement that requires revision of the gastrostomy tract is reported with 43763.
What if fluoroscopic guidance is used?
43762 describes replacement without imaging or endoscopic guidance. Fluoroscopic replacement is represented by 49450.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
5,28743756,,Dx duod intub w/asp spec,A,,0.75,8.26,,0.59,,0.07,9.08,1.41,0,000,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,28843757,,Dx duod intub w/asp specs,A,,1.23,10.84,,0.73,,0.14,12.21,2.10,0,000,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,28943761,,Reposition gastrostomy tube,A,,1.96,1.44,,0.41,,0.28,3.68,2.65,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,29043762,,Rplc gtube no revj trc,A,,0.73,7.27,,0.15,,0.15,8.15,1.03,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,29143763,,Rplc gtube revj gstrst trc,A,,1.37,9.50,,0.84,,0.28,11.15,2.49,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,29243770,,Lap place gastr adj device,A,,17.55,9.75,NA,9.75,,4.70,32.00,32.00,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,29343771,,Lap revise gastr adj device,A,,20.27,10.42,NA,10.42,,5.42,36.11,36.11,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703