Billing code 43651: Vagal electrode placementMedicare rate & RVUs

Medicare pays $633.95 for 43651 nationally in a facility.

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

What 43651 covers

This procedure places or replaces a neurostimulator electrode array at the vagus nerve using a laparoscopic approach. A surgeon performs it in an operating room, typically in a hospital or ambulatory surgical setting, for a patient whose treatment plan calls for gastric neuromodulation through vagal stimulation. The operative report should identify the electrode target and document the laparoscopic placement or replacement performed.

Report this code for the vagal electrode procedure, not for antral electrode work or for revision or removal of a previously placed vagal array. The code has a 90-day global period: the day-before preoperative visit and related postoperative care during the 90 days are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral adjustment is not appropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

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 43651 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

43651 rates by state

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

How the 43651 rate is calculated

Each of 43651’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.

Payment rules and modifiers for 43651

43651 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

43651 compared with similar codes

How to choose

43652Vagotomy

Use 43651 for placement or replacement of the vagal array; 43652 describes revision or removal of an existing array.

43647Lap impl electrode antrum

Both involve laparoscopic gastric neurostimulator electrode procedures, but 43647 addresses electrodes placed at the antrum rather than the vagus nerve.

43648Lap revise/remv eltrd antrum

43648 covers revision or removal of antral electrodes. It is not the code for placing or replacing a vagal electrode array.

43640Vagotomy

43640 reports laparoscopic vagotomy without a drainage procedure. It describes cutting vagal nerve supply, not implanting a neurostimulator electrode array.

Codes related to 43651

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

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