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CPT code 47765: Biliary bypass, extrahepatic duct, intestinal transposition2026 Medicare rate & RVUs

Reports an extrahepatic bile duct-to-intestine connection with intestinal transposition, typically used to restore bile drainage when the usual route is obstructed or disrupted.

CMS RVU26DEffective Oct 1, 2026109 payment localities75 Medicare services in 2024

Medicare pays $2,793.32 for 47765 nationally in a facility.

Medicare rate · 47765

Biliary bypass, extrahepatic duct, intestinal transposition

Office or facility?

Work RVUs
50.89
Total RVUs
83.63
Global days
090

National rate · 2026

$2,793.32

Facility setting, before claim adjustments.

See every locality for 47765 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 47765 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 47765 covers

This operation creates a route for bile from an extrahepatic duct into the gastrointestinal tract, using a transposed segment of intestine, commonly as a Roux-en-Y limb. A hepatobiliary or general surgeon may perform it for selected biliary obstruction, injury, or reconstruction when the affected duct and operative plan call for this type of bypass. The operative report should identify the duct used, the intestinal segment and reconstruction, and the completed anastomosis.

Select this code when the documented operation includes extrahepatic duct-to-bowel anastomosis with intestinal transposition; a direct anastomosis or an intrahepatic duct connection points to a different family code. This is major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is not appropriate for this anatomy. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 47765 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

47765 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,515.85
AlaskaUnavailable$3,480.11
ArizonaUnavailable$2,707.94
ArkansasUnavailable$2,482.40
Atlanta, GAUnavailable$2,900.20
Austin, TXUnavailable$2,781.78
Bakersfield, CAUnavailable$2,708.72
Baltimore area, MDUnavailable$2,975.06
Beaumont, TXUnavailable$2,703.55
Brazoria, TXUnavailable$2,700.94

47765 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
47765 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 47765 rate is calculated

Each of 47765’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 47765

RVUs × geographic indexes × conversion factor

Office or facility?

Work50.89

50.89 RVUs× 1.000 GPCI

Practice expense19.10

19.10 RVUs× 1.000 GPCI

Malpractice13.64

13.64 RVUs× 1.000 GPCI

Adjusted RVUs

83.6300

Conversion factor

$33.4009

Medicare rate

$2,793.32

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 47765

47765 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 47765

Biliary bypass, extrahepatic duct, intestinal transposition

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 47765

Biliary bypass, extrahepatic duct, intestinal transposition

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

47765 without 51 · national facility

$2,793.32

Biliary bypass, extrahepatic duct, intestinal transposition

47765-51 · Second procedure: 50%

$1,396.66

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

47765 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 47765

    Biliary bypass, extrahepatic duct, intestinal transposition50.89 wRVU

    Not priced

  • 47760

    Biliary bypass, choledochoenterostomy37.36 wRVU

    Not priced

  • 47780

    Biliary reconstruction, extrahepatic duct, Roux-en-Y41.26 wRVU

    Not priced

  • 47720

    Biliary bypass, gallbladder to bowel17.88 wRVU

    Not priced

  • 47721

    Combined bypass, gallbladder and stomach21.44 wRVU

    Not priced

How to choose

47760Biliary bypassCholedochoenterostomy
Both involve extrahepatic biliary ducts and the gastrointestinal tract. Use 47765 when intestinal transposition is part of the reconstruction; 47760 describes the related anastomosis without it.
47780Biliary reconstructionExtrahepatic duct, Roux-en-Y
47780 involves intrahepatic ducts, whereas 47765 is for an extrahepatic duct connection with intestinal transposition.
47720Biliary bypassGallbladder to bowel
47720 connects the common bile duct directly to intestine. Select 47765 when the operation instead uses the extrahepatic biliary reconstruction with intestinal transposition.
47721Combined bypassGallbladder and stomach
47721 describes a common bile duct-to-intestine Roux-en-Y reconstruction; 47765 represents the extrahepatic duct reconstruction with intestinal transposition.

Codes related to 47765

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 47765
CodeHow it relatesNational office range
Same family
47760Biliary bypass, choledochoenterostomyRelated extrahepatic duct-to-gastrointestinal anastomosis without intestinal transposition.No office rate
Used instead
47780Biliary reconstruction, extrahepatic duct, Roux-en-YBiliary-enteric anastomosis involving intrahepatic ducts.No office rate
47785Biliary-enteric anastomosis, bile duct to bowelIntrahepatic duct-to-gastrointestinal reconstruction with intestinal transposition.No office rate
47720Biliary bypass, gallbladder to bowelConnects the common bile duct directly to intestine rather than using this extrahepatic reconstruction.No office rate
47721Combined bypass, gallbladder and stomachCommon bile duct-to-intestine reconstruction using a Roux-en-Y approach.No office rate

47765 billing questions

How does this differ from 47760?

47765 includes intestinal transposition in the extrahepatic duct-to-gastrointestinal tract reconstruction. Use 47760 for the related anastomosis without that transposition.

When would 47780 or 47785 be more appropriate?

Those codes describe connections involving intrahepatic ducts. Choose the code that matches the duct location and reconstruction documented in the operative report.

Is modifier 50 appropriate?

No. The anatomy and service are not reported as bilateral, so modifier 50 is inappropriate.

What is included in the global period?

The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How does the multiple-procedure rule affect payment?

For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 47765PPRRVU2026_Oct_nonQPP.csv, line 5,723 (RVU26D)

Open CMS sourceHow we calculate rates

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