Summary & Overview
CPT 43820: Gastrojejunostomy, Stomach to Proximal Jejunum
CPT code 43820 represents a gastrojejunostomy procedure in which the surgeon creates an anastomosis between the stomach and the proximal loop of the jejunum without dividing the vagus nerve. This code captures a specific operative technique used to restore gastric outflow or bypass obstructed distal stomach or duodenum and is relevant across hospitals and surgical centers nationwide. It matters for national reimbursement, registry classification, and quality measurement because it distinguishes the procedure’s technical approach and vagal nerve preservation.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context for the procedure, coding considerations for billing teams, and common modifiers associated with surgical services. The publication provides benchmarks and policy context where available, discussion of typical sites of service, and guidance on documentation elements tied to the operative description. Data not available in the input will be noted as such rather than extrapolated. The content is intended to support revenue cycle, clinical coding, and surgical service line stakeholders in understanding how CPT code 43820 is used and where it fits within broader procedural coding and billing workflows.
Billing Code Overview
CPT code 43820 describes a surgical procedure in which the provider creates an anastomosis (connection) between the stomach and the proximal loop of the jejunum without dividing the vagus nerve. This procedure is a type of gastrojejunostomy intended to establish continuity between the stomach and the small intestine.
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Service type: Open or laparoscopic surgical gastrointestinal anastomosis
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Typical site of service: Operating room, inpatient or outpatient surgical facility
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old with complicated peptic ulcer disease and gastric outlet obstruction who presents with progressive postprandial vomiting, weight loss, and failure of endoscopic therapy. After preoperative evaluation including labs, imaging, and anesthesia clearance, the general surgeon performs an open or laparoscopic gastrojejunostomy, creating an anastomosis between the stomach and the proximal jejunal loop without dividing the vagus nerve, to bypass the obstructed gastric outlet. The clinical workflow includes preoperative consent and optimization, intraoperative inspection of the stomach and proximal small bowel, creation of the gastrojejunostomy anastomosis, hemostasis, and abdominal closure, followed by postoperative monitoring for bowel function return, pain control, wound care, and discharge planning with dietary advancement and follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier - standard reporting | Use when no reportable circumstances require a modifier. |
| 11 | Office or outpatient service as the correct designation | Use when the procedure is performed in the facility’s regular setting without unusual circumstances.
| 22 | Increased procedural services | Use when substantially greater work is required (e.g., extensive adhesiolysis) and documented.