-----BEGIN PRIVACY-ENHANCED MESSAGE-----
Proc-Type: 2001,MIC-CLEAR
Originator-Name: webmaster@www.sec.gov
Originator-Key-Asymmetric:
 MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen
 TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB
MIC-Info: RSA-MD5,RSA,
 PjzluS1qDG+jIuOyDwoRP0KYtZ2NIkMu7YSe7tgehlsW5EnLB4/I9jC/7Yl7omXH
 SEPiT/TCYfunnZFQzQxgGA==

<SEC-DOCUMENT>0000351721-03-000245.txt : 20030821
<SEC-HEADER>0000351721-03-000245.hdr.sgml : 20030821
<ACCEPTANCE-DATETIME>20030821151059
ACCESSION NUMBER:		0000351721-03-000245
CONFORMED SUBMISSION TYPE:	4
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20030820
FILED AS OF DATE:		20030821

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			MERRILL F ROBERT III
		CENTRAL INDEX KEY:			0001192859

	FILING VALUES:
		FORM TYPE:		4
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	000-10521
		FILM NUMBER:		03860066

	MAIL ADDRESS:	
		STREET 1:		6501 WINDCREST DR
		STREET 2:		SUITE 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>f4merrill082003_ex.xml
<TEXT>
<XML>
<?xml version="1.0"?>
<!-- - EDGAR Ease Plus 1.0                                   07/25/03  TT    -->
<ownershipDocument>
    <schemaVersion>X0201</schemaVersion>

    <documentType>4</documentType>
   <periodOfReport>2003-08-20</periodOfReport>
   <notSubjectToSection16>0</notSubjectToSection16>
    <issuer>
        <issuerCik>0000351721</issuerCik>
        <issuerName>ADVANCED NEUROMODULATION SYSTEMS INC</issuerName>
        <issuerTradingSymbol>ANSI</issuerTradingSymbol>
   </issuer>
   <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001192859</rptOwnerCik>
            <rptOwnerName>MERRILL F ROBERT III</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>6501 WINDCREST DR</rptOwnerStreet1>
            <rptOwnerStreet2>SUITE 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>EVP-Finance and CFO</officerTitle>
      </reportingOwnerRelationship>
   </reportingOwner>
 <nonDerivativeTable>
   <nonDerivativeTransaction>
      <securityTitle>
         <value>Common Stock</value>
      </securityTitle>
      <transactionDate>
         <value>2003-08-20</value>
      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>M</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>5027</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>19.02</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>A</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>12529</value>
         </sharesOwnedFollowingTransaction>
      </postTransactionAmounts>
      <ownershipNature>
         <directOrIndirectOwnership>
            <value>D</value>
         </directOrIndirectOwnership>
      </ownershipNature>
   </nonDerivativeTransaction>
   <nonDerivativeTransaction>
      <securityTitle>
         <value>Common Stock</value>
      </securityTitle>
      <transactionDate>
         <value>2003-08-20</value>
      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>S</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>5027</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>39.41</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>D</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>7502</value>
         </sharesOwnedFollowingTransaction>
      </postTransactionAmounts>
      <ownershipNature>
         <directOrIndirectOwnership>
            <value>D</value>
         </directOrIndirectOwnership>
      </ownershipNature>
   </nonDerivativeTransaction>
   <nonDerivativeTransaction>
      <securityTitle>
         <value>Common Stock</value>
      </securityTitle>
      <transactionDate>
         <value>2003-08-20</value>
      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>M</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>471</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>10.25</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>A</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>7973</value>
         </sharesOwnedFollowingTransaction>
      </postTransactionAmounts>
      <ownershipNature>
         <directOrIndirectOwnership>
            <value>D</value>
         </directOrIndirectOwnership>
      </ownershipNature>
   </nonDerivativeTransaction>
   <nonDerivativeTransaction>
      <securityTitle>
         <value>Common Stock</value>
      </securityTitle>
      <transactionDate>
         <value>2003-08-20</value>
      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>S</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>471</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>39.41</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>D</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>7502</value>
         </sharesOwnedFollowingTransaction>
      </postTransactionAmounts>
      <ownershipNature>
         <directOrIndirectOwnership>
            <value>D</value>
         </directOrIndirectOwnership>
      </ownershipNature>
   </nonDerivativeTransaction>
   <nonDerivativeTransaction>
      <securityTitle>
         <value>Common Stock</value>
      </securityTitle>
      <transactionDate>
         <value>2003-08-20</value>
      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>M</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>112</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>8.17</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>A</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>7614</value>
         </sharesOwnedFollowingTransaction>
      </postTransactionAmounts>
      <ownershipNature>
         <directOrIndirectOwnership>
            <value>D</value>
         </directOrIndirectOwnership>
      </ownershipNature>
   </nonDerivativeTransaction>
   <nonDerivativeTransaction>
      <securityTitle>
         <value>Common Stock</value>
      </securityTitle>
      <transactionDate>
         <value>2003-08-20</value>
      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>S</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>112</value>
         </transactionShares>
         <transactionPricePerShare>
           <value>39.41</value>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>D</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>7502</value>
         </sharesOwnedFollowingTransaction>
      </postTransactionAmounts>
      <ownershipNature>
         <directOrIndirectOwnership>
            <value>D</value>
         </directOrIndirectOwnership>
      </ownershipNature>
   </nonDerivativeTransaction>
 </nonDerivativeTable>
 <derivativeTable>
   <derivativeTransaction>
      <securityTitle>
         <value>Stock Option</value>
      </securityTitle>
      <conversionOrExercisePrice>
         <value>19.02</value>
      </conversionOrExercisePrice>
      <transactionDate>
         <value>2003-08-20</value>
      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>M</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
            <footnoteId id="F2"/>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>5027</value>
         </transactionShares>
         <transactionPricePerShare>
            <footnoteId id="F1"/>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>D</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <exerciseDate>
         <value>2003-08-20</value>
      </exerciseDate>
      <expirationDate>
         <value>2012-02-21</value>
      </expirationDate>
      <underlyingSecurity>
         <underlyingSecurityTitle>
           <value>Common Stock</value>
         </underlyingSecurityTitle>
         <underlyingSecurityShares>
           <value>5027</value>
         </underlyingSecurityShares>
      </underlyingSecurity>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>15271</value>
         </sharesOwnedFollowingTransaction>
      </postTransactionAmounts>
      <ownershipNature>
         <directOrIndirectOwnership>
           <value>D</value>
         </directOrIndirectOwnership>
      </ownershipNature>
   </derivativeTransaction>
   <derivativeTransaction>
      <securityTitle>
         <value>Stock Option</value>
      </securityTitle>
      <conversionOrExercisePrice>
         <value>10.25</value>
      </conversionOrExercisePrice>
      <transactionDate>
         <value>2003-08-20</value>
      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>M</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
            <footnoteId id="F2"/>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>471</value>
         </transactionShares>
         <transactionPricePerShare>
            <footnoteId id="F1"/>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>D</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <exerciseDate>
         <value>2003-08-20</value>
      </exerciseDate>
      <expirationDate>
         <value>2010-03-17</value>
      </expirationDate>
      <underlyingSecurity>
         <underlyingSecurityTitle>
           <value>Common Stock</value>
         </underlyingSecurityTitle>
         <underlyingSecurityShares>
           <value>471</value>
         </underlyingSecurityShares>
      </underlyingSecurity>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>0</value>
         </sharesOwnedFollowingTransaction>
      </postTransactionAmounts>
      <ownershipNature>
         <directOrIndirectOwnership>
           <value>D</value>
         </directOrIndirectOwnership>
      </ownershipNature>
   </derivativeTransaction>
   <derivativeTransaction>
      <securityTitle>
         <value>Stock Option</value>
      </securityTitle>
      <conversionOrExercisePrice>
         <value>8.17</value>
      </conversionOrExercisePrice>
      <transactionDate>
         <value>2003-08-20</value>
      </transactionDate>
      <transactionCoding>
         <transactionFormType>4</transactionFormType>
         <transactionCode>M</transactionCode>
         <equitySwapInvolved>0</equitySwapInvolved>
            <footnoteId id="F3"/>
      </transactionCoding>
      <transactionAmounts>
         <transactionShares>
           <value>112</value>
         </transactionShares>
         <transactionPricePerShare>
            <footnoteId id="F1"/>
         </transactionPricePerShare>
         <transactionAcquiredDisposedCode>
           <value>D</value>
         </transactionAcquiredDisposedCode>
      </transactionAmounts>
      <exerciseDate>
         <value>2003-08-20</value>
      </exerciseDate>
      <expirationDate>
         <value>2010-06-01</value>
      </expirationDate>
      <underlyingSecurity>
         <underlyingSecurityTitle>
           <value>Common Stock</value>
         </underlyingSecurityTitle>
         <underlyingSecurityShares>
           <value>112</value>
         </underlyingSecurityShares>
      </underlyingSecurity>
      <postTransactionAmounts>
         <sharesOwnedFollowingTransaction>
           <value>0</value>
         </sharesOwnedFollowingTransaction>
      </postTransactionAmounts>
      <ownershipNature>
         <directOrIndirectOwnership>
           <value>D</value>
         </directOrIndirectOwnership>
      </ownershipNature>
   </derivativeTransaction>
 </derivativeTable>
   <footnotes>
      <footnote id="F1"> Option grant.</footnote>

      <footnote id="F2"> Sold pursuant to the 1998 Stock Option Plan, 25% vesting per year.</footnote>

      <footnote id="F3"> Sold pursuant to the 1995 Stock Option Plan, 25% vesting per year.</footnote>
   </footnotes>
   <ownerSignature>
      <signatureName>Linda D. Moses, by Power of Attorney</signatureName>
      <signatureDate>2003-08-20</signatureDate>
   </ownerSignature>
</ownershipDocument>

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