CPT code 43647: Gastric stimulator leads, laparoscopic approach2026 Medicare rate & RVUs in Florida
Reports laparoscopic placement or replacement of gastric neurostimulator electrodes in the stomach antrum, commonly as part of treatment for gastroparesis.
CMS doesn’t publish an office rate for 43647 in Florida.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | Unavailable |
| Miami, FL | Unavailable | Unavailable |
| Rest of Florida | Unavailable | Unavailable |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | YYY | The Medicare contractor sets the global period. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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%).
43647 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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.
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