43640 Vagotomy Medicare reimbursement rates in Maine

This operation combines a truncal or selective vagotomy, which reduces vagal stimulation of gastric acid secretion, with pyloroplasty to widen the pyloric outlet and improve stomach emptying. A surgeon typically performs it through an abdominal incision for a patient whose treatment requires both steps, such as selected cases of complicated or refractory peptic ulcer disease. The code represents the combined operation, not vagotomy alone or pyloroplasty alone.

Report it when the operative note supports both the vagotomy and the pyloroplasty; document the approach, nerve division performed, and drainage procedure. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.