Find policies, billing codes, payers, states, and providers

CPT 43840: Repair and Suture of Stomach Tear

CPT code 43840 denotes surgical suturing of a tear in the stomach wall, commonly performed for gastric perforations from peptic ulcer disease or traumatic injury. This operative repair is a critical emergency or urgent procedure to close full-thickness gastric defects and prevent peritonitis, sepsis, and other severe complications. Nationally, timely recognition and operative management of gastric perforation affect patient outcomes and hospital resource use.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, sites of service, and typical service lines associated with CPT code 43840. The publication also summarizes common billing considerations, typical modifiers used with operative codes, and benchmarking themes relevant to hospitals and surgical groups. Additionally, the content outlines where to look for policy updates and payer-specific coverage patterns that can affect prior authorization and claims adjudication.

This resource is intended for revenue cycle leaders, surgical administrators, and clinicians seeking a clear, national-level reference on the clinical meaning and billing context for CPT code 43840.

Customize your policy alerts

Sign up for cpt 43840 policy alerts

Get alerted when payer policies referencing 43840 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CPT code 43840 describes the surgical repair and suturing of a tear in the stomach wall. This procedure addresses full-thickness defects that may result from a peptic ulcer that has eroded through the gastric wall or from an external traumatic injury.

Service type: Surgical repair (open or laparoscopic) of gastric perforation/tear
Typical site of service: Hospital operating room or surgicenter, commonly performed by general or trauma surgeons under operative care

Find policies, billing codes, payers, states, and providers

CPT 43840: Repair and Suture of Stomach Tear

Customize your policy alerts

Sign up for cpt 43840 policy alerts

Get alerted when payer policies referencing 43840 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service type: Surgical repair (open or laparoscopic) of gastric perforation/tear
Typical site of service: Hospital operating room or surgicenter, commonly performed by general or trauma surgeons under operative care

Clinical & Coding Specifications

Clinical Context

A typical patient is a 56-year-old male who presents to the emergency department with acute-onset, severe epigastric pain, rebound tenderness, hypotension, and signs of peritonitis. Imaging (CT abdomen) shows free intraperitoneal air and contrast extravasation suggestive of a perforated gastric ulcer. The patient is taken urgently to the operating room for exploratory laparotomy. Intraoperatively the surgeon identifies a full-thickness gastric wall defect and performs primary repair with layered suturing, irrigation, and possible omental (Graham) patch as needed. The clinical workflow includes preoperative resuscitation and antibiotics, anesthesia evaluation, informed consent, operative documentation of the gastric tear and repair, intraoperative specimen handling if biopsy is taken, postoperative monitoring in the PACU or ICU depending on hemodynamic stability, and discharge planning with instructions for acid suppression and H. pylori testing when indicated.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the gastric repair requires substantially greater work than typical due to extensive contamination, adhesions, or complex reconstruction.
`23`	Unusual anesthesia	Use when general anesthesia cannot be used and an unusual anesthesia circumstance is reported per payer rules (rare for this procedure).
`26`	Professional component	Use if reporting a separately payable professional component for a diagnostic service provided by the surgeon (uncommon for this operative CPT).
`50`	Bilateral procedure	Generally not applicable but used if bilateral stomach procedures are reported (rare/typically not used).
`51`	Multiple procedures	Use when other distinct surgical procedures are performed in the same session in addition to gastric repair.
`52`	Reduced services	Use when the procedure is intentionally partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances before completion.
`58`	Staged procedure/related procedure or service by same physician during postoperative period	Use when a planned staged procedure follows initial repair during the global period.
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure that is not normally billed with the gastric repair when appropriate.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the repair.
`66`	Surgical team	Use when a surgical team with multiple surgeons provides the repair.
`78`	Return to OR for related procedure during global period	Use if the patient returns to the OR for a related complication (e.g., leak repair) during the global period.
`79`	Unrelated procedure or service by same physician during the postoperative period	Use when an unrelated procedure is performed during the global period.

Taxonomy Code	Specialty	Notes
207L00000X	General Surgery	Most common specialty performing gastric tear repair and primary suturing.
2080P0207X	Trauma Surgery	Applies when repair is performed following blunt or penetrating trauma in a trauma service.
208000000X	Surgical Critical Care	Often involved in perioperative management of critically ill patients undergoing repair.
207K00000X	Gastroenterology	May be involved in pre- or postoperative endoscopic diagnosis; does not typically perform open surgical repair.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K25.4`	Chronic or unspecified gastric ulcer with perforation	Gastric ulcer eroding through the wall causing a perforation that necessitates surgical repair.
`K27.4`	Peptic ulcer, site unspecified, with perforation	Represents perforated peptic ulcer disease requiring suture repair.
`K92.2`	Gastrointestinal hemorrhage, unspecified	Significant bleeding from a gastric ulcer may be associated and require intraoperative control alongside repair.
`S36.041A`	Laceration of stomach, initial encounter	Traumatic laceration to the stomach from penetrating or blunt trauma requiring surgical suturing.
`K29.7`	Gastritis, unspecified	Underlying gastritis may be present as contributing pathology to ulceration and perforation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49000`	Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)	Performed immediately prior to definitive gastric tear repair when the abdominal cavity is explored to identify the source of contamination or perforation.
`43281`	Repair of perforation of the esophagus, stomach, or duodenum; via endoscopic approach	Alternative, less invasive approach when a perforation is amenable to endoscopic repair rather than open surgical repair.
`49560`	Repair recurrent incisional hernia with mesh; reducible or incarcerated	May be performed in the same operative session if an incisional hernia is encountered and requires repair (example of multiple procedures).
`49020`	Drainage of peritoneal abscess or localized peritonitis, open or percutaneous	Often performed in the same setting to control contamination from a perforated gastric ulcer when localized abscess is present.
`44120`	Enterolysis (lysis of adhesions), single or multiple sites, open	May be required if dense adhesions are present and must be lysed to access and repair the gastric tear.

CPT 43800: Repair of Pylorus by Stretching to Increase Pyloric Caliber

CPT-43810-GASTRODUODENAL-ANASTOMOSIS

CPT 43810: Gastroduodenal Anastomosis — Stomach to Duodenum Surgical Connection

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

CPT 43820: Gastrojejunostomy, Stomach 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 Enteral Access

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

CPT 43831: Infant Gastrostomy Placement for Enteral Feeding

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

CPT 43832: Surgical Gastric Access for Enteral Feeding or Decompression

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

CPT 43842: Gastric Resection of Ghrelin-Producing Portion for Morbid Obesity

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

CPT 43843: Restrictive or Partial Stomach Resection for Morbid Obesity

CPT-43845-GASTRIC-BYPASS-BARIATRIC-SURGERY

CPT 43845: Gastric Bypass Bariatric Surgery

Showing 1–10 of 24

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.

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
`22`	Increased procedural services	Use when the gastric repair requires substantially greater work than typical due to extensive contamination, adhesions, or complex reconstruction.
`23`	Unusual anesthesia	Use when general anesthesia cannot be used and an unusual anesthesia circumstance is reported per payer rules (rare for this procedure).
`26`	Professional component	Use if reporting a separately payable professional component for a diagnostic service provided by the surgeon (uncommon for this operative CPT).
`50`	Bilateral procedure	Generally not applicable but used if bilateral stomach procedures are reported (rare/typically not used).
`51`	Multiple procedures	Use when other distinct surgical procedures are performed in the same session in addition to gastric repair.
`52`	Reduced services	Use when the procedure is intentionally partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances before completion.
`58`	Staged procedure/related procedure or service by same physician during postoperative period	Use when a planned staged procedure follows initial repair during the global period.
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure that is not normally billed with the gastric repair when appropriate.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the repair.
`66`	Surgical team	Use when a surgical team with multiple surgeons provides the repair.
`78`	Return to OR for related procedure during global period	Use if the patient returns to the OR for a related complication (e.g., leak repair) during the global period.
`79`	Unrelated procedure or service by same physician during the postoperative period	Use when an unrelated procedure is performed during the global period.

Taxonomy Code	Specialty	Notes
207L00000X	General Surgery	Most common specialty performing gastric tear repair and primary suturing.
2080P0207X	Trauma Surgery	Applies when repair is performed following blunt or penetrating trauma in a trauma service.
208000000X	Surgical Critical Care	Often involved in perioperative management of critically ill patients undergoing repair.
207K00000X	Gastroenterology	May be involved in pre- or postoperative endoscopic diagnosis; does not typically perform open surgical repair.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K25.4`	Chronic or unspecified gastric ulcer with perforation	Gastric ulcer eroding through the wall causing a perforation that necessitates surgical repair.
`K27.4`	Peptic ulcer, site unspecified, with perforation	Represents perforated peptic ulcer disease requiring suture repair.
`K92.2`	Gastrointestinal hemorrhage, unspecified	Significant bleeding from a gastric ulcer may be associated and require intraoperative control alongside repair.
`S36.041A`	Laceration of stomach, initial encounter	Traumatic laceration to the stomach from penetrating or blunt trauma requiring surgical suturing.
`K29.7`	Gastritis, unspecified	Underlying gastritis may be present as contributing pathology to ulceration and perforation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49000`	Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)	Performed immediately prior to definitive gastric tear repair when the abdominal cavity is explored to identify the source of contamination or perforation.
`43281`	Repair of perforation of the esophagus, stomach, or duodenum; via endoscopic approach	Alternative, less invasive approach when a perforation is amenable to endoscopic repair rather than open surgical repair.
`49560`	Repair recurrent incisional hernia with mesh; reducible or incarcerated	May be performed in the same operative session if an incisional hernia is encountered and requires repair (example of multiple procedures).
`49020`	Drainage of peritoneal abscess or localized peritonitis, open or percutaneous	Often performed in the same setting to control contamination from a perforated gastric ulcer when localized abscess is present.
`44120`	Enterolysis (lysis of adhesions), single or multiple sites, open	May be required if dense adhesions are present and must be lysed to access and repair the gastric tear.

CPT 43800: Repair of Pylorus by Stretching to Increase Pyloric Caliber

CPT-43810-GASTRODUODENAL-ANASTOMOSIS

CPT 43810: Gastroduodenal Anastomosis — Stomach to Duodenum Surgical Connection

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

CPT 43820: Gastrojejunostomy, Stomach 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 Enteral Access

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

CPT 43831: Infant Gastrostomy Placement for Enteral Feeding

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

CPT 43832: Surgical Gastric Access for Enteral Feeding or Decompression

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

CPT 43842: Gastric Resection of Ghrelin-Producing Portion for Morbid Obesity

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

CPT 43843: Restrictive or Partial Stomach Resection for Morbid Obesity

CPT-43845-GASTRIC-BYPASS-BARIATRIC-SURGERY

CPT 43845: Gastric Bypass Bariatric Surgery

Showing 1–10 of 24

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.

OpenPayer

CPT 43840: Repair and Suture of Stomach Tear

Sign up for cpt 43840 policy alerts

Billing Code Overview

Catch payer policy changes before they impact reimbursement

Catch payer policy changes before they impact reimbursement

OpenPayer

CPT 43840: Repair and Suture of Stomach Tear

Sign up for cpt 43840 policy alerts

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