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CPT code 43647: Gastric stimulator leads, laparoscopic approach2026 Medicare rate & RVUs

Reports laparoscopic placement or replacement of gastric neurostimulator electrodes in the stomach antrum, commonly as part of treatment for gastroparesis.

CMS RVU26DEffective Oct 1, 2026109 payment localities144 Medicare services in 2024

Medicare rate · 43647

Gastric stimulator leads, laparoscopic approach

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
YYY

National rate · 2026

—

Not priced in the facility setting.

See every locality for 43647 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 43647 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 43647 covers

This surgical service places or replaces gastric neurostimulator electrodes in the stomach antrum using a laparoscopic approach. A surgeon typically performs it in a hospital operating room for a patient receiving gastric electrical stimulation, often for severe, persistent symptoms associated with gastroparesis. The electrode procedure concerns the leads in the stomach; placement or replacement of the pulse generator is a separate service when performed and reported.

Medicare assigns CPT 43647 carrier-priced status (status C): there is no national payment amount, and the Medicare Administrative Contractor sets payment for each claim. The contractor also sets the global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%. Report the code for the laparoscopic electrode procedure; code selection differs for open placement and for laparoscopic revision or removal.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 43647 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

43647 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

43647 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
43647 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 43647 rate is calculated

Each of 43647’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 43647

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 43647

The CMS indicators that decide how 43647 is paid alongside other services.

CMS payment indicators · 43647

Gastric stimulator leads, laparoscopic approach

RuleCMS valueWhat it means
Global periodYYYThe Medicare contractor sets the global period.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

43647 without 51 · national facility

$0.00

Gastric stimulator leads, laparoscopic approach

43647-51 · Second procedure: 50%

$0.00

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

43647 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 43647

    Gastric stimulator leads, laparoscopic approach0 wRVU

    Not priced

  • 43648

    Electrode revision, gastric neurostimulator0 wRVU

    Not priced

  • 43881

    Gastric electrodes, open antral procedure0 wRVU

    Not priced

  • 64590

    Neurostimulator generator, pulse generator or receiver4.97 wRVU

    $428.20

How to choose

43648Electrode revisionGastric neurostimulator
Choose 43647 for laparoscopic electrode placement or replacement; 43648 is for laparoscopic electrode revision or removal.
43881Gastric electrodesOpen antral procedure
This code describes the open approach for gastric neurostimulator electrode placement or replacement; 43647 is the laparoscopic approach.
64590Neurostimulator generatorPulse generator or receiver
64590 describes the pulse generator or receiver, while 43647 describes the laparoscopic placement or replacement of electrodes in the stomach antrum.

Codes related to 43647

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 43647
CodeHow it relatesNational office range
Same family
43648Electrode revision, gastric neurostimulatorLaparoscopic revision or removal of gastric neurostimulator electrodes.No office rate
Used instead
43881Gastric electrodes, open antral procedureOpen approach for gastric neurostimulator electrode placement or replacement.No office rate
Often billed with
64590Neurostimulator generator, pulse generator or receiverDescribes placement or replacement of the gastric neurostimulator pulse generator.$382.84–$540.26

43647 billing questions

When should 43647 be used instead of 43648?

Use 43647 for laparoscopic placement or replacement of the gastric neurostimulator electrodes. Code 43648 describes laparoscopic revision or removal of those electrodes.

Is the pulse generator included in this service?

The electrode procedure and pulse-generator placement or replacement are distinct services. When both are performed, 64590 describes the generator service.

How many units are reported?

Report the laparoscopic electrode procedure as one surgical service for the operative session, rather than counting individual electrodes as units.

What operative documentation supports 43647?

Document the laparoscopic approach and that gastric neurostimulator electrodes were placed or replaced in the stomach antrum. Distinguish this work from generator placement and from electrode revision or removal.

How does Medicare price 43647?

It has carrier-priced status C, so CMS publishes no national payment amount and the Medicare Administrative Contractor sets payment for each claim. The contractor also sets the global period.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates

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