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CPT 43647: Laparoscopic Gastric Stimulation Electrode Placement

CPT code 43647 identifies laparoscopic placement of gastric stimulation electrodes on the gastric antrum for patients with refractory gastroparesis. The procedure is clinically significant because it offers an interventional option for symptom control when medical therapy fails, and it has implications for surgical practice patterns, device utilization, and payer coverage decisions nationwide. Major payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise explanation of the clinical indication and procedural setting, a summary of payer coverage patterns and common modifiers used with the code, and benchmark-oriented observations relevant to utilization and site-of-service considerations. The publication also outlines typical places where the service is delivered (hospital outpatient departments and ambulatory surgery centers) and highlights the clinical context of gastroparesis management. Data not available in the input for specific tariff rates, utilization volumes, or ICD-10 mappings is noted where applicable.

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Billing Code Overview

CPT code 43647 describes laparoscopic placement of gastric stimulation electrodes on the antrum of the stomach. The procedure is used when medical management of gastroparesis (stomach paralysis, often a complication of diabetes mellitus) has been insufficient and involves implanting electrodes to provide gastric electrical stimulation.

Service Type: Surgical implant procedure — laparoscopic gastric neurostimulation electrode placement

Typical Site of Service: Hospital outpatient surgical suite or ambulatory surgery center (laparoscopic operative setting)

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CPT 43647: Laparoscopic Gastric Stimulation Electrode Placement

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Billing Code Overview

Service Type: Surgical implant procedure — laparoscopic gastric neurostimulation electrode placement

Typical Site of Service: Hospital outpatient surgical suite or ambulatory surgery center (laparoscopic operative setting)

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with refractory gastroparesis, often diabetic, who continues to experience severe nausea, vomiting, early satiety, weight loss, and inability to tolerate oral intake despite optimized medical therapy (prokinetics, antiemetics, glycemic control, enteral nutrition where needed). The gastroenterologist evaluates symptoms, confirms delayed gastric emptying by gastric emptying scintigraphy, and documents failure of conservative measures. The surgical team (laparoscopic surgeon with experience in gastric stimulators) obtains informed consent and plans laparoscopic placement of gastric electrical stimulation leads on the antrum (43647). Preoperative workflow includes medical optimization, anesthesia evaluation, perioperative antibiotic prophylaxis, and device planning with neuromodulation supplier. Intraoperative steps include laparoscopic access, identification of the gastric antrum, placement and fixation of electrodes, tunneling of leads, and connection to an implanted pulse generator (often placed in a subcutaneous abdominal pocket either during the same anesthetic or in a staged fashion). Postoperative workflow includes device programming, pain control, nausea management, wound care, and follow-up visits with the implanting team and gastroenterology for symptom assessment and adjustment of stimulation parameters.

Coding Specifications

Modifier	Description	When to Use
`00`	Service provided without a specific modifier	Rarely used; default when no modifier applies
`22`	Increased procedural services	Use when intraoperative work is substantially greater than typical (document rationale and time)
`23`	Unusual anesthesia (patient condition)	Use when general anesthesia is contraindicated and significant concerns necessitate unusual anesthesia coding
`52`	Reduced services	Use when procedure is partially completed or components omitted but medically indicated
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances before completion
`54`	Surgical care only	Use when another surgeon provides pre/postoperative care and this claim is for intraoperative surgical services only
`55`	Postoperative management only	Use when billing physician provided only postoperative care related to `43647`
`62`	Two surgeons	Use when assistance by another surgeon of the same specialty is required for difficult dissection or complications
`66`	Surgical team	Use for procedures requiring a surgical team (document team roles)
`78`	Return to operating room for a related procedure during the postoperative period	Use when patient requires reoperation related to the original `43647` within global period
`80`	Assistant surgeon	Use when an assistant (resident or another surgeon) assists and payer recognizes assistant payments
`81`	Minimum assistant surgeon	Use when minimal assistance is provided and payer recognizes this modifier
`82`	Assistant surgeon when a qualified resident is unavailable	Use when a non-physician or physician assistant provides assistance due to resident unavailability and payer allows
`AS`	Physician is the primary anesthesiologist	Use when reporting anesthesiology services by the primary anesthesiologist for the case

Taxonomy Code	Specialty	Notes
`207L00000X`	General Surgery	Most common surgical specialty performing laparoscopic gastric stimulator placement
`2080P0206X`	Gastroenterology	Involved for diagnosis, preoperative evaluation, and postoperative device management and programming
`208600000X`	Colon & Rectal Surgery	Occasionally involved if combined foregut procedures or complex abdominal surgical history exists
`207K00000X`	Surgeons — Body Surface	Used by surgeons specializing in abdominal operations where device placement is performed
`208100000X`	Neuromodulation Specialist / Pain Medicine	May be involved for programming or multidisciplinary management of implantable stimulators

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K31.84`	Gastroparesis	Primary indication for gastric electrical stimulation when medical therapy fails
`E11.9`	Type 2 diabetes mellitus without complications	Common underlying etiology associated with diabetic gastroparesis
`E10.9`	Type 1 diabetes mellitus without complications	Common underlying etiology associated with diabetic gastroparesis
`R11.0`	Nausea with vomiting	Frequent symptom driving consideration for device therapy when refractory
`R63.5`	Abnormal weight gain	May be recorded if weight change occurs post-therapy or as part of nutritional assessment
`R63.4`	Abnormal weight loss	Relevant when patients have weight loss from chronic vomiting and poor gastric emptying
`Z43.3`	Encounter for attention to gastrostomy (e.g., feeding tube)	Relevant when enteral access is present or considered as adjunct therapy
`T82.7XXA`	Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter	Used analogously for device-related infection coding if implant infection occurs (use most specific device infection code available)

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`43280`	Endoscopic placement of nasojejunal or nasogastric tube; with guidance	Used preoperatively or as temporary nutritional support when gastroparesis requires enteral feeding prior to or instead of definitive device placement
`49568`	Implantation or replacement of abdominal wall port or catheter, subcutaneous port	May be billed when creating a subcutaneous pocket for a pulse generator or implantable device if reported by certain payers (verify payer rules)
`20680`	Removal of implant; deep (e.g., stimulator lead)	Used when explantation of gastric stimulation electrodes or leads is required due to infection, malfunction, or revision
`95970`	Electronic analysis of implanted neurostimulator pulse generator system (reprogramming)	Used for device programming, interrogation, and adjustments performed postoperatively by device clinic
`43645`	Laparoscopy, surgical; implantation of gastric neurostimulator (includes lead placement) [Note: code for open or different approach if applicable]	Related laparoscopic code set; used by some payers for variant approaches—verify correct code selection and payer policy

CPT 43644: Laparoscopic Gastric Bypass with Stomach-to-Jejunum Bypass

CPT-43645-GASTRIC-BYPASS-SMALL-GASTRIC-RESERVOIR-ROUX-EN

CPT 43645: Gastric Bypass with Small Gastric Reservoir

CPT-43648-LAPAROSCOPIC-GASTRIC-NEUROSTIMULATOR-ELECTRODE-MANAGEMENT

CPT 43648: Laparoscopic Management of Gastric Neurostimulator Electrodes

CPT-43651-LAPAROSCOPIC-TRUNCAL-VAGOTOMY-FOR-DUODENAL-ULCER

CPT 43651: Laparoscopic Truncal Vagotomy for Duodenal Ulcer

CPT-43652-LAPAROSCOPIC-SELECTIVE-HIGHLY-SELECTIVE-VAGOTOMY

CPT 43652: Laparoscopic Selective or Highly Selective Vagotomy

CPT-43653-GASTRIC-TUBE-PLACEMENT-FOR-ENTERAL-ACCESS

CPT 43653: Gastric Tube Placement for Enteral Access

CPT-43659-UNLISTED-LAPAROSCOPIC-STOMACH-PROCEDURE

CPT 43659: Unlisted Laparoscopic Procedure on the Stomach

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	Service provided without a specific modifier	Rarely used; default when no modifier applies
`22`	Increased procedural services	Use when intraoperative work is substantially greater than typical (document rationale and time)
`23`	Unusual anesthesia (patient condition)	Use when general anesthesia is contraindicated and significant concerns necessitate unusual anesthesia coding
`52`	Reduced services	Use when procedure is partially completed or components omitted but medically indicated
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances before completion
`54`	Surgical care only	Use when another surgeon provides pre/postoperative care and this claim is for intraoperative surgical services only
`55`	Postoperative management only	Use when billing physician provided only postoperative care related to `43647`
`62`	Two surgeons	Use when assistance by another surgeon of the same specialty is required for difficult dissection or complications
`66`	Surgical team	Use for procedures requiring a surgical team (document team roles)
`78`	Return to operating room for a related procedure during the postoperative period	Use when patient requires reoperation related to the original `43647` within global period
`80`	Assistant surgeon	Use when an assistant (resident or another surgeon) assists and payer recognizes assistant payments
`81`	Minimum assistant surgeon	Use when minimal assistance is provided and payer recognizes this modifier
`82`	Assistant surgeon when a qualified resident is unavailable	Use when a non-physician or physician assistant provides assistance due to resident unavailability and payer allows
`AS`	Physician is the primary anesthesiologist	Use when reporting anesthesiology services by the primary anesthesiologist for the case

Taxonomy Code	Specialty	Notes
`207L00000X`	General Surgery	Most common surgical specialty performing laparoscopic gastric stimulator placement
`2080P0206X`	Gastroenterology	Involved for diagnosis, preoperative evaluation, and postoperative device management and programming
`208600000X`	Colon & Rectal Surgery	Occasionally involved if combined foregut procedures or complex abdominal surgical history exists
`207K00000X`	Surgeons — Body Surface	Used by surgeons specializing in abdominal operations where device placement is performed
`208100000X`	Neuromodulation Specialist / Pain Medicine	May be involved for programming or multidisciplinary management of implantable stimulators

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K31.84`	Gastroparesis	Primary indication for gastric electrical stimulation when medical therapy fails
`E11.9`	Type 2 diabetes mellitus without complications	Common underlying etiology associated with diabetic gastroparesis
`E10.9`	Type 1 diabetes mellitus without complications	Common underlying etiology associated with diabetic gastroparesis
`R11.0`	Nausea with vomiting	Frequent symptom driving consideration for device therapy when refractory
`R63.5`	Abnormal weight gain	May be recorded if weight change occurs post-therapy or as part of nutritional assessment
`R63.4`	Abnormal weight loss	Relevant when patients have weight loss from chronic vomiting and poor gastric emptying
`Z43.3`	Encounter for attention to gastrostomy (e.g., feeding tube)	Relevant when enteral access is present or considered as adjunct therapy
`T82.7XXA`	Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter	Used analogously for device-related infection coding if implant infection occurs (use most specific device infection code available)

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`43280`	Endoscopic placement of nasojejunal or nasogastric tube; with guidance	Used preoperatively or as temporary nutritional support when gastroparesis requires enteral feeding prior to or instead of definitive device placement
`49568`	Implantation or replacement of abdominal wall port or catheter, subcutaneous port	May be billed when creating a subcutaneous pocket for a pulse generator or implantable device if reported by certain payers (verify payer rules)
`20680`	Removal of implant; deep (e.g., stimulator lead)	Used when explantation of gastric stimulation electrodes or leads is required due to infection, malfunction, or revision
`95970`	Electronic analysis of implanted neurostimulator pulse generator system (reprogramming)	Used for device programming, interrogation, and adjustments performed postoperatively by device clinic
`43645`	Laparoscopy, surgical; implantation of gastric neurostimulator (includes lead placement) [Note: code for open or different approach if applicable]	Related laparoscopic code set; used by some payers for variant approaches—verify correct code selection and payer policy

CPT 43644: Laparoscopic Gastric Bypass with Stomach-to-Jejunum Bypass

CPT-43645-GASTRIC-BYPASS-SMALL-GASTRIC-RESERVOIR-ROUX-EN

CPT 43645: Gastric Bypass with Small Gastric Reservoir

CPT-43648-LAPAROSCOPIC-GASTRIC-NEUROSTIMULATOR-ELECTRODE-MANAGEMENT

CPT 43648: Laparoscopic Management of Gastric Neurostimulator Electrodes

CPT-43651-LAPAROSCOPIC-TRUNCAL-VAGOTOMY-FOR-DUODENAL-ULCER

CPT 43651: Laparoscopic Truncal Vagotomy for Duodenal Ulcer

CPT-43652-LAPAROSCOPIC-SELECTIVE-HIGHLY-SELECTIVE-VAGOTOMY

CPT 43652: Laparoscopic Selective or Highly Selective Vagotomy

CPT-43653-GASTRIC-TUBE-PLACEMENT-FOR-ENTERAL-ACCESS

CPT 43653: Gastric Tube Placement for Enteral Access

CPT-43659-UNLISTED-LAPAROSCOPIC-STOMACH-PROCEDURE

CPT 43659: Unlisted Laparoscopic Procedure on the Stomach

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 43647: Laparoscopic Gastric Stimulation Electrode Placement

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Billing Code Overview

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OpenPayer

CPT 43647: Laparoscopic Gastric Stimulation Electrode Placement

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References