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    v1.0.30
    OpenPayerBilling CodesOther Procedures on the StomachCPT cpt-43810-gastroduodenal-anastomosis
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    CPT 43810: Gastroduodenal Anastomosis

    Medicare pays $962 on average nationally for this procedure.

    CPT code 43810 describes a gastroduodenal anastomosis, a surgical procedure to create a connection between the stomach and duodenum typically performed after excision of part of the stomach or duodenum; service type: open gastrointestinal surgical reconstruction performed in an operating room or surgical suite (inpatient or outpatient hospital settings depending on clinical indication).

    For related coverage guidance, see recent payer policy updates: Prior Authorization/Notification - Weight Loss/Appetite Suppression Medication Coverage, Liraglutide, Wegovy Tablet Benefit Exclusion Overrides Policy BMI ≥35.

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old male with a history of peptic ulcer disease complicated by gastric outlet obstruction undergoes evaluation for progressive vomiting, weight loss, and failure to thrive. Imaging and endoscopy demonstrate a distal gastric stenosis with nonhealing ulceration and partial gastric resection is planned. In the operating room under general anesthesia, the surgical team performs a partial gastrectomy with creation of a 43810 gastroduodenal anastomosis (surgical connection between the stomach and the duodenum) to restore continuity of the gastrointestinal tract. The typical workflow includes preoperative evaluation (medical clearance, informed consent, antibiotic prophylaxis), induction of anesthesia, exploratory laparotomy or laparoscopic assistance, resection of diseased gastric tissue if indicated, handsewn or stapled gastroduodenostomy, assessment for hemostasis and anastomotic integrity, placement of drains if needed, and transfer to post-anesthesia care unit for monitoring. Postoperative care involves analgesia, nausea control, early mobility, gradual advancement of diet, and monitoring for complications such as leak, bleeding, or delayed gastric emptying.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    43246Esophagogastroduodenoscopy, flexible, diagnostic, with or without collection of specimen(s) by brushing or washing (EGD)Preoperative diagnostic endoscopy to evaluate cause and extent of gastric outlet obstruction prior to gastroduodenostomy.
    43620Gastrectomy, partial, distal subtotal, with or without duodenal or other anastomosis; with reconstruction (e.g., Billroth)Alternative or accompanying resection code when partial gastrectomy is performed with reconstruction; 43810 describes the anastomosis specifically.
    44120Enterolysis (lysis of adhesions), small intestineMay be performed intraoperatively if dense adhesions are encountered prior to performing 43810.
    49422Insertion of temporary external drainage device, percutaneous or open, for postoperative drainageUsed when drains are placed at the time of gastroduodenostomy for postoperative management.
    99231Subsequent hospital care, per day, for evaluation and managementUsed for daily postoperative inpatient evaluation following 43810 by the attending surgeon.

    Related Modifiers

    8 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…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    2080S0010X
    2084P0800X
    2085H0002X
    302F00000X
    364SP0810X
    208200000X
    207SC0300X

    Related Payer Policy Updates

    Specialty: Bariatric & Obesity Management1 / 3

    10 rows

    PolicyPayerEffective Date
    Prior Authorization/Notification - Weight Loss/Appetite Suppression Medication CoverageColorado Rocky Mountain Health Plans2026-10-01
    LiraglutideCigna2026-09-01
    Wegovy Tablet Benefit Exclusion Overrides Policy BMI ≥35Cigna2026-09-01
    Weight Loss - Glucagon-Like Peptide-1 Agonists - FoundayoCigna2026-09-01
    Weight Loss - Glucagon-Like Peptide-1 Agonists - Foundayo Benefit Exclusion Overrides Policy BMI ≥35Cigna2026-09-01
    Bariatric SurgeryPremera Bluecross2026-08-01
    Bariatric Surgery (for Nebraska Only)UnitedHealthcare2026-08-01
    Bariatric Surgery (for Kentucky Only)UnitedHealthcare2026-08-01
    Bariatric (weight loss) surgery — coverage criteriaPremera Bluecross2026-08-01
    MassHealth management of anti-obesity medicationswellsense_health_plan2026-07-03

    Related Codes

    CPT-43800-PYLORIC-REPAIR-PYLOROPLASTY-STRETCHING

    CPT 43800: Pylorus Repair (Pyloroplasty/Pyloric Dilation)

    CPT-43820-GASTROJEJUNOSTOMY-STOMACH-TO-PROXIMAL-JEJUNUM

    CPT 43820: Gastrojejunostomy to Proximal Jejunum

    CPT-43825-GASTROJEJUNOSTOMY-STOMACH-TO-JEJUNUM-ANASTOMOSIS

    CPT 43825: Gastrojejunostomy, Stomach to Jejunum Anastomosis

    CPT-43830-GASTRIC-TUBE-PLACEMENT-ENTERAL-ACCESS

    CPT 43830: Gastric Tube Placement for Stomach Access

    CPT-43831-INFANT-GASTROSTOMY-PLACEMENT-FOR-ENTERAL-FEEDING

    CPT 43831: Gastrostomy Creation for Infant Enteral Feeding

    CPT-43832-GASTRIC-ACCESS-PLACEMENT-FOR-FEEDING-DECOMPRESSION

    CPT 43832: Gastrostomy Tube Insertion / Stoma Creation

    CPT-43840-GASTRIC-TEAR-REPAIR-SUTURE

    CPT 43840: Repair of Tear in Stomach Wall

    CPT-43842-GASTRIC-GHRELIN-PRODUCING-PORTION-RESECTION

    CPT 43842: Sleeve Gastrectomy Removing Ghrelin-Producing Stomach Portion

    CPT-43843-RESTRICTIVE-BARIATRIC-STOMACH-PARTIAL-RESECTION-OR-WALLING

    CPT 43843: Stomach Walling or Partial Gastrectomy for Morbid Obesity

    CPT-43845-GASTRIC-BYPASS-BARIATRIC-SURGERY

    CPT 43845: Gastric Bypass with Small Bowel Bypass

    Showing 1–10 of 24

    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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