CPT® Code 43647

Laparoscopic implantation or replacement of gastric neurostimulator electrodes within the antrum of the stomach is a surgical procedure performed to address medically refractory gastroparesis, a condition where the stomach cannot empty itself of food in a normal fashion. This procedure is commonly referred to as the placement of a gastric pacemaker. During the operation, a neurostimulator or generator is implanted into a subcutaneous pocket that is created in the abdominal wall, typically beneath the rib cage. The procedure involves the insertion of two intramuscular lead wires equipped with electrodes into the muscle wall of the stomach antrum. These electrodes are designed to deliver continuous high-frequency, low-energy electrical stimulation to the nerves of the lower stomach. The primary purpose of this electrical stimulation is to promote stomach contractions, which can significantly alleviate symptoms associated with gastroparesis, such as severe vomiting, nausea, and other gastrointestinal complications. For the initial implantation or replacement of these gastric neurostimulator electrodes via laparoscope, the appropriate code to use is 43647. In cases where there is a need for revision or removal of previously placed gastric neurostimulator electrodes, the code 43648 should be utilized.