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CPT 43644: Laparoscopic Gastric Bypass with Stomach-to-Jejunum Bypass
CPT code 43644 designates a laparoscopic gastric bypass procedure that surgically reduces stomach volume by bypassing a portion of the stomach and creating a gastrojejunostomy to the jejunum for treatment of morbid obesity. This code is a primary bariatric surgery code used in clinical practice to document minimally invasive Roux-en-Y style bypass operations performed for severe obesity.
Key national payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Coverage and prior-authorization requirements vary across payers and influence site-of-service determinations, inpatient versus outpatient classification, and documentation expectations.
Readers will find a concise review of the clinical intent of the code, expected sites of service, commonly associated diagnostic indications, and closely related procedure codes used for alternative bariatric approaches. The publication summarizes typical billing and coding relationships, common modifiers encountered on claims, and the taxonomies of physicians who commonly perform this surgery. Benchmarks and policy-relevant items include comparisons to related laparoscopic and open bariatric procedures, payer coverage scope, and coding distinctions that affect claim adjudication. This national overview is intended to clarify the clinical and administrative role of CPT code 43644 in bariatric care pathways.
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Billing Code Overview
CPT code 43644 describes a laparoscopic gastric bypass procedure in which the surgeon reduces stomach size by bypassing a portion of the stomach and creates a connection between the stomach and the jejunum to treat morbid obesity. The procedure is performed using minimally invasive laparoscopic technique.
Service Type: Bariatric surgery — laparoscopic Roux-en-Y gastric bypass (stomachojejunal anastomosis)
Typical Site of Service: Hospital outpatient surgical suite or inpatient surgical operating room, depending on clinical complexity and payer or facility requirements.
National Reimbursement Benchmarks
Medicare’s mean of $1,626.90 sits notably below BUCA’s average commercial mean of $2,253.40, highlighting a sizable gap between federal reimbursement and this commercial benchmark. This gap of $626.50 underscores different pricing dynamics: Medicare is concentrated (n=47 localities) with a tight central tendency (P25 $1,563, P50 $1,600, P75 $1,687), while BUCA’s commercial mean aligns closer to other large insurers and reflects higher commercial payment levels.
Dispersion measured by P75–P25 varies across payers: Blue Cross Blue Shield’s interquartile spread is $1,237.80, Aetna’s is $1,235.20, Cigna’s is $1,905.80, UnitedHealth Group’s is $1,955.10, and BUCA’s is $1,468.40; Medicare is the tightest with a spread of $124.00. UnitedHealth Group and Cigna show the widest IQRs, indicating greater variability in commercial contracting, while Medicare is the least variable.