CPT 0647T: Percutaneous Magnet-Assisted Gastrostomy Tube Insertion, Ultrasound-Guided - OpenPayer

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Summary & Overview

CPT 0647T: Percutaneous Magnet-Assisted Gastrostomy Tube Insertion, Ultrasound-Guided

CPT code 0647T designates a percutaneous, image-guided gastrostomy tube placement that uses magnets to appose the stomach to the abdominal wall and includes ultrasound guidance with documentation. This technique offers an alternative to traditional endoscopic or radiologic gastrostomy approaches and is notable for its use of magnet-assisted approximation combined with sonographic imaging to facilitate safe tube insertion. Nationally, the code is relevant for hospitals, ambulatory surgical centers, and payers evaluating coverage and coding for minimally invasive feeding tube placement.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for magnet-assisted percutaneous gastrostomy, coding specifics for use of CPT code 0647T, and what to expect in payer coverage patterns. The publication summarizes benchmarking considerations and documentation elements tied to ultrasound-guided procedures. It also outlines typical sites of service and operational implications for facilities that perform image-guided enteral access. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0647TCPTgastrostomyfeeding tubepercutaneous procedureultrasound guidanceinterventional radiologyambulatory surgery

Billing Code Overview

CPT code 0647T describes a procedure in which a provider inserts a gastrostomy feeding tube percutaneously through the abdominal skin using a magnet-based technique that brings the stomach to the abdominal wall. The procedure is performed with ultrasound guidance, and the service includes documentation and a formal ultrasound report.

Service type: Image-guided percutaneous gastrostomy tube insertion using magnet-assisted stomach apposition
Typical site of service: Hospital outpatient department or ambulatory surgical center where percutaneous interventional procedures with ultrasound guidance are performed

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult or pediatric patient with inadequate oral intake due to neurologic impairment, obstructive head and neck disease, or chronic dysphagia who requires long-term enteral nutrition. The patient is evaluated by a gastroenterologist or interventional radiologist and determined to need a gastrostomy tube for feeding. Under conscious sedation or general anesthesia in an ambulatory surgical center, endoscopy suite, or hospital interventional radiology suite, the provider performs a percutaneous gastrostomy placement using a magnetic gastropexy system to approximate the stomach to the anterior abdominal wall. Real-time ultrasound guidance is used to identify the stomach, avoid intervening organs and vasculature, and document the procedure. The workflow includes pre-procedure consent and time-out, ultrasound and endoscopic imaging as indicated, magnetic device placement to create apposition, percutaneous tract formation, tube insertion, securement, documentation of ultrasound images and a formal ultrasound report, and post-procedure monitoring with discharge instructions or inpatient handoff as required.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical for the procedure (document rationale and increased time/complexity).

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Taxonomy Code	Specialty	Notes
`330600000X`	Gastroenterology	Gastroenterologists commonly perform percutaneous endoscopic gastrostomy and ultrasound-guided variations.
`330400000X`	Interventional Radiology	Interventional radiologists perform image-guided percutaneous gastrostomy placements.
`208000000X`	General Surgery	Surgeons may perform surgical gastrostomy or participate in complex placements.
`208100000X`	Colon and Rectal Surgery	May be involved in complex abdominal wall or enteral access cases.
`367A00000X`	Pediatric Gastroenterology	Pediatric specialists perform gastrostomy placements for infants and children when indicated.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E46`	Unspecified protein-calorie malnutrition	Indicates inadequate nutrition where long-term enteral access may be required.
`R13.10`	Dysphagia, unspecified	Swallowing dysfunction prompting need for gastrostomy tube for safe nutrition.
`G81.90`	Hemiplegia, unspecified affecting unspecified side	Neurologic impairment causing feeding difficulties and aspiration risk.
`K35.2`	Acute or chronic conditions causing gastric outlet obstruction	Obstruction requiring alternative enteral access when oral feeding is not possible.
`Q87.1`	Congenital malformations of digestive system (example)	Pediatric congenital anomalies that may necessitate long-term enteral feeding.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`43246`	Endoscopic, transoral placement of enteral tube (e.g., percutaneous endoscopic gastrostomy)	Alternative endoscopic technique for gastrostomy tube placement; may be performed instead of magnetic-assisted percutaneous approach when endoscopy-only placement is used.
`49440`	Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including imaging guidance, and tube placement	Radiologic percutaneous gastrostomy placement using fluoroscopy; an alternative image-guided method often performed by interventional radiology.
`76998`	Ultrasound guidance for percutaneous procedures (when listed separately)	Use when ultrasound guidance is reported separately and criteria met for a distinct guidance service and documentation.
`43760`	Replacement of gastrostomy tube, percutaneous, without radiologic or endoscopic guidance	Performed later for tube exchanges or replacements following initial placement.
`49010`	Insertion of temporary gastric tube, percutaneous, without imaging guidance	Related procedure for short-term enteral access; may be an earlier or alternative approach.