$252.03–$283.58
Both involve gastrostomy tube replacement through an existing tract. Report 43763 when the tract is revised; report 43762 when replacement occurs without tract revision.
On this page
CMS RVU26D · Effective 2026-10-01
43763 G-tube replacement Medicare reimbursement rates in Pennsylvania
Report this service when a gastrostomy tube is replaced through an existing opening and the tract must also be revised. Compare 43763 office and facility rates across CMS payment localities in Pennsylvania.
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 43763 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$345.89–$388.06
2 of 2 localities have a supported rate.
Facility setting
$80.35–$86.95
2 of 2 localities have a supported rate.
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.
Gastrostomy procedures
About 43763: Percutaneous gastrostomy tube replacement with tract revision
Report this service when a gastrostomy tube is replaced through an existing opening and the tract must also be revised.
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.
CMS billing rules for 43763
- 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 RVU1.37 · 12%
- Practice expense (office) RVU9.50 · 85%
- Malpractice RVU0.28 · 3%
2.3K
Medicare services in 2024 · #2359 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.
43763 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$118.46–$127.87
43761 repositions a gastrostomy tube rather than replacing it. Report 43763 when a replacement tube is inserted and the tract is revised.
$521.66–$587.01
49450 describes percutaneous tube replacement under fluoroscopic guidance, including imaging documentation. The distinguishing work for 43763 is revision of the gastrostomy tract during replacement.
Compare 43763 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$388.06
Facility
$86.95
Rest Of Pennsylvania →
Office / nonfacility
$345.89
Facility
$80.35
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 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.
5,28843757,,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
5,29443772,,Lap rmvl gastr adj device,A,,15.31,7.51,NA,7.51,,3.97,26.79,26.79,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00