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Proc-Type: 2001,MIC-CLEAR
Originator-Name: webmaster@www.sec.gov
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MIC-Info: RSA-MD5,RSA,
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 xhAIB6vN6ESaYu7Fx9JkSA==

<SEC-DOCUMENT>0000351721-03-000328.txt : 20031202
<SEC-HEADER>0000351721-03-000328.hdr.sgml : 20031202
<ACCEPTANCE-DATETIME>20031202154818
ACCESSION NUMBER:		0000351721-03-000328
CONFORMED SUBMISSION TYPE:	4
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20031201
FILED AS OF DATE:		20031202

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			VARRICHIO ANTHONY J
		CENTRAL INDEX KEY:			0001194332

	FILING VALUES:
		FORM TYPE:		4
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	000-10521
		FILM NUMBER:		031032701

	MAIL ADDRESS:	
		STREET 1:		6501 WINDCREST DR
		STREET 2:		STE 100
		CITY:			PLANO
		STATE:			TX
		ZIP:			75024

ISSUER:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			ADVANCED NEUROMODULATION SYSTEMS INC
		CENTRAL INDEX KEY:			0000351721
		STANDARD INDUSTRIAL CLASSIFICATION:	SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
		IRS NUMBER:				751646002
		STATE OF INCORPORATION:			TX
		FISCAL YEAR END:			1231

	BUSINESS ADDRESS:	
		STREET 1:		6501 WINDCREST DRIVE SUITE 100
		CITY:			PLANO
		STATE:			TX
		ZIP:			75024
		BUSINESS PHONE:		9723098000

	MAIL ADDRESS:	
		STREET 1:		6501 WINDCREST DRIVE SUITE 100
		CITY:			PLANO
		STATE:			TX
		ZIP:			75024

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	QUEST MEDICAL INC
		DATE OF NAME CHANGE:	19920703
</SEC-HEADER>
<DOCUMENT>
<TYPE>4
<SEQUENCE>1
<FILENAME>f4varrichio120203_ex.xml
<TEXT>
<XML>
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<ownershipDocument>
    <schemaVersion>X0201</schemaVersion>

    <documentType>4</documentType>
   <periodOfReport>2003-12-01</periodOfReport>
   <notSubjectToSection16>0</notSubjectToSection16>
    <issuer>
        <issuerCik>0000351721</issuerCik>
        <issuerName>ADVANCED NEUROMODULATION SYSTEMS INC</issuerName>
        <issuerTradingSymbol>ANSI</issuerTradingSymbol>
   </issuer>
   <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001194332</rptOwnerCik>
            <rptOwnerName>VARRICHIO ANTHONY J</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>6501 WINDCREST DRIVE SUITE 100</rptOwnerStreet1>
            <rptOwnerStreet2></rptOwnerStreet2>
            <rptOwnerCity>PLANO</rptOwnerCity>
            <rptOwnerState>TX</rptOwnerState>
            <rptOwnerZipCode>75024</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
            <reportingOwnerRelationship>
         <isDirector>0</isDirector>
         <isOfficer>1</isOfficer>
         <isTenPercentOwner>0</isTenPercentOwner>
         <isOther>0</isOther>
         <officerTitle>Executive VP and CTO</officerTitle>
      </reportingOwnerRelationship>
   </reportingOwner>
 <nonDerivativeTable>
   <nonDerivativeTransaction>
      <securityTitle>
         <value>Common Stock</value>
      </securityTitle>
      <transactionDate>
         <value>2003-12-01</value>
      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>S</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
            <footnoteId id="F1"/>
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      <transactionAmounts>
         <transactionShares>
           <value>1000</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>42.50</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>D</value>
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           <value>169933</value>
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         <transactionFormType>4</transactionFormType>
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         <equitySwapInvolved>0</equitySwapInvolved>
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         <equitySwapInvolved>0</equitySwapInvolved>
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         <transactionFormType>4</transactionFormType>
         <transactionCode>S</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
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         <transactionShares>
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         <transactionPricePerShare>
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         <transactionAcquiredDisposedCode>
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         <value>Common Stock</value>
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      <transactionDate>
         <value>2003-12-01</value>
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      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>S</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
            <footnoteId id="F1"/>
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      <transactionAmounts>
         <transactionShares>
           <value>294</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>43.34</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>D</value>
         </transactionAcquiredDisposedCode>
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      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>158433</value>
         </sharesOwnedFollowingTransaction>
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         <directOrIndirectOwnership>
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            <footnoteId id="F2"/>
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      <securityTitle>
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      <transactionDate>
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      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>S</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
            <footnoteId id="F1"/>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>162</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>43.40</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>D</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>158271</value>
         </sharesOwnedFollowingTransaction>
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      <ownershipNature>
         <directOrIndirectOwnership>
            <value>D</value>
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   </nonDerivativeTransaction>
   <nonDerivativeTransaction>
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         <value>Common Stock</value>
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      <transactionDate>
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      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>S</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
            <footnoteId id="F1"/>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>627</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>43.65</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>D</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>157644</value>
         </sharesOwnedFollowingTransaction>
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      <ownershipNature>
         <directOrIndirectOwnership>
            <value>D</value>
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   </nonDerivativeTransaction>
   <nonDerivativeTransaction>
      <securityTitle>
         <value>Common Stock</value>
      </securityTitle>
      <transactionDate>
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      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>S</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
            <footnoteId id="F1"/>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>211</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>43.75</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>D</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>157433</value>
         </sharesOwnedFollowingTransaction>
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            <value>D</value>
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 </nonDerivativeTable>
   <footnotes>
      <footnote id="F1"> Sold pursuant to a Rule 10b5-1 Safe Harbor Plan.</footnote>

      <footnote id="F2"> 2,666 owned indirectly, by Spouse.</footnote>
   </footnotes>
   <ownerSignature>
      <signatureName>Linda D. Moses, by Power of Attorney</signatureName>
      <signatureDate>2003-12-02</signatureDate>
   </ownerSignature>
</ownershipDocument>

</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
-----END PRIVACY-ENHANCED MESSAGE-----