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2025 CPT code 43633

Partial distal gastrectomy with Roux-en-Y reconstruction.

Modifiers may be applicable to this code to indicate specific circumstances, such as increased procedural services (22), multiple procedures (51), or other situations that affect the standard procedure.

Medical necessity for this procedure is determined by the underlying condition. It is typically performed for conditions like stomach cancer, intractable ulcers, or as part of bariatric surgery for severe obesity when less invasive treatments are unsuccessful.

The surgeon performs the partial distal gastrectomy and the Roux-en-Y reconstruction. This includes mobilizing the stomach and duodenum, dividing the duodenum, creating the Roux-en-Y limb, and performing the anastomoses. The surgeon also ensures the patient is properly prepared for the procedure and manages post-operative care.

In simple words: The surgeon removes the lower part of the stomach. The remaining upper stomach is then reconnected to the small intestine using a specific technique called a Roux-en-Y to create a new digestive pathway. This helps patients consume and absorb fewer calories.

This procedure involves removing the lower portion of the stomach and reconstructing the digestive tract by connecting the remaining stomach to a section of the small intestine (jejunum) using a Roux-en-Y anastomosis. The Roux-en-Y limb, a segment of the small intestine, is brought up and connected to the stomach remnant, creating a new pathway for food to bypass the duodenum. The distal end of the duodenum is then attached further down the small intestine, allowing digestive juices from the pancreas and liver to mix with the food stream.

Example 1: A patient with distal stomach cancer undergoes a partial gastrectomy with Roux-en-Y reconstruction to remove the tumor and restore digestive function., A patient with a non-cancerous but non-operable ulcer in the lower part of their stomach undergoes this procedure to alleviate symptoms., A patient with severe obesity who has not responded to other weight loss methods may have this procedure as part of bariatric surgery.

Operative report detailing the procedure, including the extent of resection, reconstruction technique, and any complications. Pre-operative diagnostic reports justifying the medical necessity of the procedure (e.g., imaging, biopsies).

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