CPT code 43659: Laparoscopic stomach procedure, unlisted procedure2026 Medicare rate & RVUs in Missouri
Reports a laparoscopic stomach operation that has no specific CPT code, with the surgeon's operative details supporting contractor review and claim pricing.
CMS doesn’t publish an office rate for 43659 in Missouri.
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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On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
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
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
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician 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).
43659 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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