<SUBMISSION>
<ACCESSION-NUMBER>0000351721-03-000230
<TYPE>4/A
<PUBLIC-DOCUMENT-COUNT>1
<PERIOD>20030801
<FILING-DATE>20030813
<REPORTING-OWNER>
<OWNER-DATA>
<CONFORMED-NAME>VARRICHIO ANTHONY J
<CIK>0001194332
</OWNER-DATA>
<FILING-VALUES>
<FORM-TYPE>4/A
<ACT>34
<FILE-NUMBER>000-10521
<FILM-NUMBER>03841058
</FILING-VALUES>
<MAIL-ADDRESS>
<STREET1>6501 WINDCREST DR
<STREET2>STE 100
<CITY>PLANO
<STATE>TX
<ZIP>75024
</MAIL-ADDRESS>
</REPORTING-OWNER>
<ISSUER>
<COMPANY-DATA>
<CONFORMED-NAME>ADVANCED NEUROMODULATION SYSTEMS INC
<CIK>0000351721
<ASSIGNED-SIC>3841
<IRS-NUMBER>751646002
<STATE-OF-INCORPORATION>TX
<FISCAL-YEAR-END>1231
</COMPANY-DATA>
<BUSINESS-ADDRESS>
<STREET1>6501 WINDCREST DRIVE SUITE 100
<CITY>PLANO
<STATE>TX
<ZIP>75024
<PHONE>9723098000
</BUSINESS-ADDRESS>
<MAIL-ADDRESS>
<STREET1>6501 WINDCREST DRIVE SUITE 100
<CITY>PLANO
<STATE>TX
<ZIP>75024
</MAIL-ADDRESS>
<FORMER-COMPANY>
<FORMER-CONFORMED-NAME>QUEST MEDICAL INC
<DATE-CHANGED>19920703
</FORMER-COMPANY>
</ISSUER>
<DOCUMENT>
<TYPE>4/A
<SEQUENCE>1
<FILENAME>f4varrichio080103a_ex.xml
<TEXT>
<XML>
<?xml version="1.0"?>
<!-- - EDGAR Ease Plus 1.0                                   07/25/03  TT    -->
<ownershipDocument>
    <schemaVersion>X0201</schemaVersion>

    <documentType>4/A</documentType>
   <periodOfReport>2003-08-01</periodOfReport>
   <dateOfOriginalSubmission>2003-08-04</dateOfOriginalSubmission>
   <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 DR</rptOwnerStreet1>
            <rptOwnerStreet2>STE 100</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>2001-12-28</value>
      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>G</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>1350</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>23.087</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>A</value>
            <footnoteId id="F1"/>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>224933</value>
         </sharesOwnedFollowingTransaction>
      </postTransactionAmounts>
      <ownershipNature>
         <directOrIndirectOwnership>
            <value>D</value>
         </directOrIndirectOwnership>
      </ownershipNature>
   </nonDerivativeTransaction>
   <nonDerivativeTransaction>
      <securityTitle>
         <value>Common Stock</value>
      </securityTitle>
      <transactionDate>
         <value>2003-08-01</value>
      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>S</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
            <footnoteId id="F2"/>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>13500</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>39.7242</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>D</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>211433</value>
            <footnoteId id="F3"/>
         </sharesOwnedFollowingTransaction>
      </postTransactionAmounts>
      <ownershipNature>
         <directOrIndirectOwnership>
            <value>D</value>
         </directOrIndirectOwnership>
      </ownershipNature>
   </nonDerivativeTransaction>
 </nonDerivativeTable>
   <footnotes>
      <footnote id="F1"> Gift of 900 shares recinded.</footnote>

      <footnote id="F2"> Sold pursuant to a Rule 10b5-1 Safe Harbor Plan.</footnote>

      <footnote id="F3"> 2,666 held indirectly, by Spouse.</footnote>
   </footnotes>
   <ownerSignature>
      <signatureName>Linda D. Moses, by Power of Attorney</signatureName>
      <signatureDate>2003-08-13</signatureDate>
   </ownerSignature>
</ownershipDocument>

</XML>
</TEXT>
</DOCUMENT>
</SUBMISSION>
