43640 Vagotomy & pylorus repair
Also known as: vagotomy and pyloroplasty, open vagotomy, V&P
Vagotomy and pyloroplasty via open approach for peptic ulcer disease or gastric outlet obstruction.
In Plain Language
stomach nerve cutting and opening of outlet; ulcer surgery
Clinical Context
Historically used for treatment of peptic ulcer disease and gastric acid hypersecretion, now rarely performed due to proton pump inhibitors. Used for severe gastric outlet obstruction.
RVU Breakdown
| Work RVU | 19.07 |
| Total RVU | 19.07 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 90-day global period, which includes the day of the procedure, 1 day preoperative, and 90 days of postoperative care. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 19.07, this code ranks in the 81st percentile among Surgery codes — 2.4x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 43640?
CPT 43640 (Vagotomy & pylorus repair) is a Surgery code. Vagotomy and pyloroplasty via open approach for peptic ulcer disease or gastric outlet obstruction.
What is the wRVU value for CPT 43640?
The work RVU for CPT 43640 is 19.07. This code is primarily used by General Surgery, Colorectal Surgery. It has a 90-day global period.
When is CPT 43640 used?
Historically used for treatment of peptic ulcer disease and gastric acid hypersecretion, now rarely performed due to proton pump inhibitors. Used for severe gastric outlet obstruction.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.