2025 CPT code 43763
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Introduction Procedures on the Stomach Surgical Procedures on the Digestive System Feed
Replacement of a percutaneous gastrostomy tube requiring revision of the gastrostomy tract without imaging guidance.
Modifiers may be applicable depending on the circumstances of the procedure. Examples include modifier 52 (reduced services) if the revision was less extensive than expected, or modifier 26 (professional component) if billed separately from the technical component.
The medical necessity for this procedure is established when the existing gastrostomy tube needs replacement due to malfunction (dislodgement, blockage, infection), or requires tract revision for proper function. The replacement must be medically necessary for nutritional support, medication delivery, or decompression of the stomach.
The clinical responsibility lies with the surgeon or qualified healthcare professional performing the procedure. This includes pre-operative assessment, removal of the old tube, evaluation of the gastrostomy tract, repair of the tract as needed, placement of the new tube, and post-operative monitoring.
- Surgical Procedures on the Digestive System
- Surgical Procedures on the Digestive System > Surgical Procedures on the Stomach > Introduction Procedures on the Stomach
In simple words: This code covers replacing a feeding tube in the stomach.The old tube is removed, the opening is fixed if needed, and a new tube is put in without the use of special imaging.
This CPT code encompasses the percutaneous replacement of a gastrostomy tube, including removal of the existing tube, when necessary.The procedure requires revision of the gastrostomy tract due to issues such as stenosis, obstruction, or infection.The replacement is performed without the use of imaging or endoscopic guidance. The procedure involves removing the old tube, assessing and repairing the gastrostomy tract, and inserting a new tube, securing it in place.
Example 1: A patient's gastrostomy tube becomes dislodged. The surgeon removes the tube, finds the tract is slightly narrowed, dilates it, and inserts a new tube., A patient's gastrostomy tube becomes clogged and infected.The surgeon removes the tube, cleans the tract, treats the infection, and inserts a new tube., A patient's gastrostomy tube develops a leak around the site.The surgeon removes the tube, repairs the tract, and places a new, properly sized tube.
* Detailed operative report describing the procedure.* Pre-operative and post-operative notes.* Images (if any) demonstrating the condition of the tract.* Any pathology reports related to biopsies taken during the procedure.* Patient's history of prior gastrostomy tube placement.* Evidence of medical necessity and appropriateness of the replacement.
** Always ensure that the medical record accurately reflects the procedure performed to support the use of this code.If the tract did not require revision, use code 43762 instead.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: This information is not provided in the source and varies by payer and location. Consult your local Medicare Administrative Contractor (MAC) for specific Relative Value Units (RVUs) and reimbursement rates.
- Global Days: The global period for this procedure is not specified in the provided data.This will depend on payer-specific policies. Consult your local payer for specific global period guidelines.
- Payment Status: Active
- Modifier TC rule: The technical component (TC) may be billed separately from the professional component (PC) depending on who performed each portion of the procedure.Consult your local payer for guidance.
- Fee Schedule: This information is not available in the source data. Fee schedules vary by payer and location.Consult your local payer for information on historical fee schedules.
- Specialties:General Surgery, Gastroenterology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center