Summary & Overview
CPT 43825: Gastrojejunostomy, Stomach to Jejunum Anastomosis
CPT code 43825 denotes a surgical gastrojejunostomy: construction of an anastomosis between the stomach and jejunum. This operative procedure is an established technique for bypassing the duodenum and is frequently used in the management of complicated duodenal ulcer disease and other indications requiring gastric diversion. Nationally, it is a relevant inpatient and outpatient surgical billing category because it spans general and bariatric surgery practices and can impact hospital surgical case mix and resource utilization.
Key payers examined in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context, coding description, and typical sites of service, alongside payer coverage considerations and commonly reported modifiers. The publication outlines how CPT code 43825 is used in surgical practice, summarizes common billing patterns, and highlights where policy updates or payer-specific documentation requirements may affect coding and reimbursement workflows.
This national summary is intended to orient clinicians, coding professionals, and administrators to the procedure represented by CPT code 43825, what to expect across major payers, and which operational and documentation topics to review when handling cases that involve gastrojejunostomy.
Billing Code Overview
CPT code 43825 describes a surgical procedure in which the provider constructs an anastomosis between the stomach and the jejunum. The operation establishes a direct gastrointestinal connection (gastrojejunostomy) and is commonly performed for conditions such as complicated duodenal ulcer disease and other indications requiring gastric diversion.
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Service type: Surgical open or laparoscopic gastrointestinal anastomosis (gastrojejunostomy)
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Typical site of service: Hospital inpatient or outpatient surgical setting, including operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with a history of complicated peptic ulcer disease presents with persistent epigastric pain, vomiting, and weight loss despite medical therapy. Endoscopy demonstrates gastric outlet obstruction related to chronic duodenal ulceration and pyloric channel scarring. After preoperative evaluation and medical optimization, the surgical team performs a gastrojejunostomy to bypass the obstructed proximal duodenum and restore enteric continuity. The operation is performed in an operating room under general anesthesia with endotracheal intubation. The typical clinical workflow includes preoperative consent and testing, induction of anesthesia, open or laparoscopic creation of the gastric-to-jejunal anastomosis, intraoperative assessment for hemostasis and leak testing, placement of drains if indicated, postoperative monitoring in the PACU and surgical ward, and follow-up for wound care and nutritional progression. Concurrent procedures such as vagotomy for ulcer disease or feeding tube placement may be performed depending on intraoperative findings and patient needs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier/Not a real CMS modifier (placeholder) | Data not applicable — not typically used as an explicit modifier code in claims. |
11 |