Billing code 43763: G-tube replacementMedicare rate & RVUs in Ohio
Report this service when a gastrostomy tube is replaced through an existing opening and the tract must also be revised.
Medicare pays $344.89 for 43763 in the office in Ohio (Ohio). 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 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.
43763 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $344.89 | $80.80 |
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.
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
| 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
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%).
43763 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 43762G-tube replacement
- Both involve gastrostomy tube replacement through an existing tract. Report 43763 when the tract is revised; report 43762 when replacement occurs without tract revision.
- 43761G-tube repositioning
- 43761 repositions a gastrostomy tube rather than replacing it. Report 43763 when a replacement tube is inserted and the tract is revised.
- 49450Feeding tube replacement
- 49450 describes percutaneous tube replacement under fluoroscopic guidance, including imaging documentation. The distinguishing work for 43763 is revision of the gastrostomy tract during replacement.
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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