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    v1.0.30
    OpenPayerBilling CodesLaparoscopic Procedures on the StomachCPT cpt-43648-laparoscopic-gastric-neurostimulator-electrode-management
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    CPT 43648: Laparoscopic Gastric Neurostimulator Revision or Removal

    CPT code 43648 describes a laparoscopic procedure to test, adjust, or remove previously placed gastric neurostimulator electrodes used to stimulate gastric emptying for conditions such as gastroparesis; service type: device revision/removal and troubleshooting of implanted gastric neurostimulator leads; typical site of service: operating room or ambulatory surgical center with laparoscopic equipment for minimally invasive abdominal surgery.

    For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 48-year-old patient with longstanding type 1 diabetes mellitus presents with refractory gastroparesis despite optimized medical therapy (dietary measures, prokinetic agents). The patient previously underwent laparoscopic implantation of a gastric neurostimulator and now reports return of severe nausea, vomiting, and poor gastric emptying. Preoperative evaluation includes device interrogation, gastric emptying study, and review of system contraindications. On the day of service the surgeon performs a laparoscopic procedure to test and adjust previously placed gastric neurostimulator electrodes; intraoperative testing identifies inadequate electrode function requiring repositioning or removal. The clinical workflow includes preoperative device testing by the surgical team or device representative, general anesthesia in an ambulatory surgery center or hospital operating room, laparoscopic access to the gastric wall, electrode interrogation and adjustment or explantation as needed, verification of device function, closure of port sites, and postoperative monitoring for immediate complications such as bleeding, infection, or gastric leak. Typical postoperative documentation includes operative report detailing electrode testing methods, adjustments made, any removal, device serial numbers, anesthesia time, and postoperative plan for device reprogramming or replacement if indicated.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    43280Esophagogastroduodenoscopy, flexible, transoral; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)May be performed pre- or postoperatively to evaluate mucosal integrity or exclude obstruction before neurostimulator adjustment or explantation
    47562Laparoscopic, cholecystectomy; with exploration of common duct (when indicated)Not directly related but represents similar laparoscopic access and skills; listed as commonly performed laparoscopic procedures in the same operative setting when indicated
    93290Programming device evaluation; simple or complex, first hourDevice interrogation and programming of implanted gastric neurostimulator may be billed separately under neuromodulation device programming codes when available
    95983Continuous neurostimulation up to one hour of intraoperative physiological testing (temporarily placed leads)May apply when intraoperative testing of gastric stimulation thresholds and physiologic response is performed during electrode adjustment
    43659Unlisted procedure, stomach, laparoscopicUse only if the intraoperative activity does not fit 43648 and no specific code accurately describes the performed procedure
    99152Moderate sedation services provided by the same physician performing a therapeutic serviceUse when moderate sedation, rather than general anesthesia, is documented for device testing or minor revision (billing rules vary)

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207LP2900X
    208000000X
    207T00000X
    261QR0207X
    163WC2100X
    1835P0018X
    2086S0127X
    344800000X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    E08.40Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified
    E08.9Diabetes mellitus due to underlying condition without complications
    E11.40Type 2 diabetes mellitus with diabetic neuropathy, unspecified
    E11.9Type 2 diabetes mellitus without complications
    E13.40Other specified diabetes mellitus with diabetic neuropathy, unspecified
    E13.9Other specified diabetes mellitus without complications
    G25.82Stiff-man syndrome
    G90.4Autonomic dysreflexia
    G91.9Hydrocephalus, unspecified
    I10Essential (primary) hypertension

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    Anesthesia Services for Interventional Pain Management Procedures in an AdultCigna2026-09-15
    General Anesthesia and Conscious Sedation ServicesUnitedHealthcare2026-09-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-43644-LAPAROSCOPIC-GASTRIC-BYPASS-STOMACH-TO-JEJUNUM

    CPT 43644: Laparoscopic Gastric Bypass with Gastrojejunostomy

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

    CPT 43645: Laparoscopic Roux-en-Y Gastric Bypass

    CPT-43647-LAPAROSCOPIC-GASTRIC-STIMULATION-ELECTRODE-PLACEMENT

    CPT 43647: Laparoscopic Gastric Stimulation Electrode Placement

    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: Percutaneous Endoscopic Gastrostomy Tube Placement

    CPT-43659-UNLISTED-LAPAROSCOPIC-STOMACH-PROCEDURE

    CPT 43659: Laparoscopic Procedure on Stomach, Unlisted

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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