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CPT code 43659: Laparoscopic stomach procedure, unlisted procedure2026 Medicare rate & RVUs

Reports a laparoscopic stomach operation that has no specific CPT code, with the surgeon's operative details supporting contractor review and claim pricing.

CMS RVU26DEffective Oct 1, 2026109 payment localities4.7K Medicare services in 2024

Medicare rate · 43659

Laparoscopic stomach procedure, unlisted procedure

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 43659 →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 43659 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 43659 covers

Use this code for a laparoscopic operation on the stomach when no more specific CPT code describes the work performed. The surgeon performs and reports the procedure, typically in an operating room. It is not a substitute for a defined laparoscopic service, such as gastric bypass, gastrostomy creation, or gastric electrical-stimulation electrode placement. The operative report should identify the indication, approach, anatomy treated, work completed, and why a listed code does not describe the service.

Medicare assigns this code physician fee schedule status C: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The contractor also sets the global period. This is a procedure code, not a dose-based code. The operative documentation is central to explaining the service represented by the unlisted code.

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 43659 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

43659 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

43659 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
43659 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 43659 rate is calculated

Each of 43659’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 · 43659

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 43659

The CMS indicators that decide how 43659 is paid alongside other services.

CMS payment indicators · 43659

Laparoscopic stomach procedure, unlisted procedure

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

43659 without 50 · national facility

$0.00

Laparoscopic stomach procedure, unlisted procedure

43659-50 · Bilateral: 150%

$0.00

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

43659 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 43659

    Laparoscopic stomach procedure, unlisted procedure0 wRVU

    Not priced

  • 43644

    Gastric bypass, roux-en-Y, laparoscopic28.67 wRVU

    Not priced

  • 43645

    Gastric bypass, small-intestine reconstruction30.74 wRVU

    Not priced

  • 43653

    Gastrostomy, laparoscopic approach8.27 wRVU

    Not priced

  • 43648

    Electrode revision, gastric neurostimulator0 wRVU

    Not priced

How to choose

43644Gastric bypassRoux-en-Y, laparoscopic
43644 is for a defined laparoscopic Roux-en-Y gastric bypass. Use 43659 only when the stomach operation performed is not represented by a specific code.
43645Gastric bypassSmall-intestine reconstruction
43645 covers a separately defined laparoscopic gastric bypass procedure. The operative details determine whether it fits; 43659 is for an operation without a matching specific code.
43653GastrostomyLaparoscopic approach
43653 describes laparoscopic gastrostomy creation. It is not an unlisted stomach-operation code; report 43659 only when the performed service is not that defined procedure or another specific CPT service.
43648Electrode revisionGastric neurostimulator
43648 identifies laparoscopic revision or removal of a gastric antrum electrode. It describes work on an existing electrode, rather than an otherwise unlisted stomach operation.

Codes related to 43659

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

Codes related to 43659
CodeHow it relatesNational office range
Used instead
43644Gastric bypass, roux-en-Y, laparoscopicUse for the defined laparoscopic Roux-en-Y gastric bypass procedure rather than an unlisted code when it matches.No office rate
43645Gastric bypass, small-intestine reconstructionUse when the performed laparoscopic gastric bypass matches this separately defined procedure.No office rate
43653Gastrostomy, laparoscopic approachUse for laparoscopic gastrostomy creation when that is the operation performed.No office rate
43647Gastric stimulator leads, laparoscopic approachUse for laparoscopic placement of a gastric antrum stimulation electrode when that defined service is performed.No office rate

43659 billing questions

When should 43659 be used instead of a specific laparoscopic stomach code?

Use 43659 when the operation performed does not match a more specific CPT code. If the procedure is a defined service such as laparoscopic gastric bypass or gastrostomy creation, report the code for that service instead.

What operative documentation supports 43659?

Document the indication, laparoscopic approach, stomach anatomy treated, and the work performed. The report should make clear why a listed CPT code does not represent the operation.

How does Medicare price 43659?

It has physician fee schedule status C. CMS publishes no national payment; the Medicare Administrative Contractor sets payment for each claim.

Who sets the global period for this code?

The Medicare Administrative Contractor sets the global period for 43659.

Is 43659 the code for laparoscopic gastric bypass?

Not when the operation matches a specific bypass code. For example, 43644 and 43645 describe defined laparoscopic gastric bypass procedures; use 43659 only when no specific code describes the actual operation.

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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