Summary & Overview
CPT 64755: Surgical Vagotomy to Reduce Gastric Secretion
CPT code 64755 designates a surgical vagotomy that severs or removes branches of the vagus nerve near the stomach to reduce gastric acid secretion when other therapies fail. Nationally, the code captures a specialized surgical intervention for patients with refractory peptic ulcer disease or pathological gastric hypersecretion and is relevant to hospital surgical services, surgical coding accuracy, and payer coverage policies.
Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, common billing modifiers (provided separately), and guidance on where to locate related coding references. The publication summarizes benchmarks and policy considerations relevant to hospital-based surgical billing, highlights documentation elements that affect coding and medical necessity review, and outlines potential areas for payer coverage variability.
This summary provides clinicians, coders, and policy professionals with the primary clinical definition of the procedure, the payer landscape covered, and an overview of topics explored in the full publication, including reimbursement benchmarks, coding guidance, and policy updates. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 64755 describes a surgical procedure in which the provider severs or removes one or more branches of the vagus nerve nearest to the stomach to reduce the rate of gastric secretion when other measures cannot achieve reduction. This procedure is used in the treatment of peptic ulcer disease or refractory gastric hypersecretion when nonoperative options are unsuccessful.
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Service type: Surgical vagotomy procedure to reduce gastric acid secretion
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Typical site of service: Inpatient or outpatient surgical setting (operating room) depending on clinical indication and patient status
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with refractory peptic ulcer disease or complicated gastric ulceration (bleeding or recurrent ulcers) who has failed maximal medical therapy including proton pump inhibitors and H. pylori eradication when indicated. The patient presents with persistent epigastric pain, recurrent upper gastrointestinal bleeding, or nonhealing gastric/duodenal ulcer despite endoscopic therapy and medical management. After multidisciplinary evaluation by gastroenterology and general or thoracic surgery, the surgeon schedules truncal or selective vagotomy targeting branches of the vagus nerve near the stomach to reduce gastric acid secretion.
Preoperative workflow includes history and physical, upper endoscopy to document ulcer disease, H. pylori testing and treatment as indicated, assessment of comorbidities, informed consent addressing risks (bleeding, infection, gastric emptying changes), and anesthesia evaluation. The procedure is typically performed in an operating room under general anesthesia, often via an open or laparoscopic approach. Postoperative care includes monitoring for complications, pain control, gradual advancement of diet, and follow-up with gastroenterology and surgery for ulcer surveillance and management of gastric motility changes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When the work, time, or complexity is substantially greater than typical for the procedure. |