PEG Tube Placement CPT Code for 2018

What is the CPT Code for a PEG tube placement?

The code for a PEG tube placement is (however you may want to read further to see if other codes are more appropriate for the procedure performed):

43246  Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube

Surgery > Digestive System > Esophagus > Endoscopy

Total Non-Facility and Facility RVUs: 5.88


National Correct Coding Initiative (NCCI) Bundling Edits for Code 43246

43246 Includes the following CPT Codes:

Unbundling never allowed:
00520 00731 00732 00811 00812 00813 0213T 0216T 0228T 0230T 31505 31525 31575 36591 36592 43180 43191 43197 43198 43200 43201 43202 43204 43205 43206 43210 43211 43212 43213 43214 43215 43216 43217 43220 43226 43227 43229 43231 43232 43235 43754 44360 44376 62320 62321 62322 62323 62324 62325 62326 62327 64400 64402 64405 64408 64410 64413 64415 64416 64417 64418 64420 64421 64425 64430 64435 64445 64446 64447 64448 64449 64450 64461 64462 64463 64479 64480 64483 64484 64486 64487 64488 64489 64490 64491 64492 64493 64494 64495 64505 64508 64510 64517 64520 64530 69990 92511 94760 94761 99155 99156 99157 99446 99447 99448 99449

Unbundling allowed w/ modifier Other: 59 XE XS XP XU Anatomic: LT RT Global: 58 78 79 as appropriate:
12001 12002 12004 12005 12006 12007 12011 12013 12014 12015 12016 12017 12018 12020 12021 12031 12032 12034 12035 12036 12037 12041 12042 12044 12045 12046 12047 12051 12052 12053 12054 12055 12056 12057 13100 13101 13102 13120 13121 13122 13131 13132 13133 13151 13152 13153 36000 36005 36010 36011 36012 36013 36014 36015 36400 36405 36406 36410 36420 36425 36430 36440 36600 36640 43236 43241 43247 43255 43752 43753 43756 43760 43761 44361 44363 44365 44373 51701 51702 51703 76000 76001 77001 77002 92012 92014 93000 93005 93010 93040 93041 93042 93318 93355 94002 94200 94250 94680 94681 94690 94770 95812 95813 95816 95819 95822 95829 95955 96360 96361 96365 96366 96367 96368 96372 96374 96375 96376 96377 99152 99211 99212 99213 99214 99215 99217 99218 99219 99220 99221 99222 99223 99231 99232 99233 99234 99235 99236 99238 99239 99241 99242 99243 99244 99245 99251 99252 99253 99254 99255 99291 99292 99304 99305 99306 99307 99308 99309 99310 99315 99316 99334 99335 99336 99337 99347 99348 99349 99350 99374 99375 99377 99378 99495 99496 G0463 G0471

43246 is Include in the following CPT Codes:

Unbundling allowed w/ modifier Other: 59 XE XS XP XU Anatomic: LT RT Global: 58 78 79 as appropriate:
43610 43611 43620 43621 43622 43631 43632 43633 43634 43640 43641 43800 43810 43820 43825 43832 43846 43847 43850 43855 43865 44364 44366 44369 44370 44372 44377 44378 44379 96570

43246 is considered Mutually Exclusive with the following CPT Codes:

Unbundling never allowed:
43192 43193 43194 43195 43196 49440


Description of A Percutaneous Endoscopic Gastrostomy (PEG) Tube

By Gilo1969 – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=5776677

A percutaneous endoscopic gastrostomy (PEG) is a tube inserted to provide medicine, liquids and food directly into the stomach. The procedure is typically done for patients who are having difficulty swallowing.

If you would like to learn how the placement is performed please see the article: Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement Technique

Other Related Codes That May Be More Appropriate

This is not a simple one code answer for this question, as there are several CPT codes relating to PEG (percutaneous endoscopic gastrostomy) tube placement, replacement or conversion and it depends on what approach and guidance is used.  Below is a list of CPT codes and descriptions that involve PEG Tubes. Also included is their status, global days and total Facility RVUS :

Code Status Global Description
43752 A 000 Naso- or oro-gastric tube placement, requiring physician’s skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report)

Surgery > Digestive System > Stomach > Introduction

Total Non-Facility and Facility RVUs:: 1.18

43760 A 000 Change of gastrostomy tube, percutaneous, without imaging or endoscopic guidance

Surgery > Digestive System > Stomach > Introduction

Total Facility RVUs: 1.36
Total Non-Facility RVUs: 14.1

49440 A 010 Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report

Surgery > Digestive System > Abdomen, Peritoneum, and Omentum > Introduction, Revision, Removal > Initial Placement

Total Facility RVUs: 5.98
Total Non-Facility RVUs: 27.48

49446 A 090 Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report

Surgery > Digestive System > Abdomen, Peritoneum, and Omentum > Introduction, Revision, Removal

Total Facility RVUs: 4.31
Total Non-Facility RVUs: 26.47

49450 A 000 Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report

Surgery > Digestive System > Abdomen, Peritoneum, and Omentum > Introduction, Revision, Removal > Replacement

Total Facility RVUs: 1.93
Total Non-Facility RVUs: 18.94

 

Summary

43246 is probably the most appropriate code if you are looking for a true percutaneous endoscopic gastrostomy(PEG) tube. However, as you can see there are a handful of other procedures that may have been performed and should be considered.  As always, we recommend that you choose the most accurate code that describes the procedure(s) performed.