CPT code 47765: Biliary bypass, extrahepatic duct, intestinal transposition2026 Medicare rate & RVUs in Iowa
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.
In Iowa, Medicare pays $2,464.37 for 47765 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 47765 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Iowa compares for 47765
Across 109 of 109 payment localities, the facility rate for 47765 runs from $2,451.26 in Wisconsin to $3,516.07 in Miami, FL. Iowa pays $2,464.37. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$2,464.37
- Los Angeles, CA · California$2,826.68+$362.31
- Washington, DC area · District of Columbia$3,050.14+$585.77
- Miami, FL · Florida$3,516.07+$1,051.70
- Chicago, IL · Illinois$3,398.39+$934.02
- Manhattan, NY · New York$3,272.43+$808.06
- Alaska · Alaska$3,480.11+$1,015.74
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $2,515.85 |
| ArkansasArkansas | — | $2,482.40 |
| ArizonaArizona | — | $2,707.94 |
| Bakersfield, CACalifornia | — | $2,708.72 |
| Chico, CACalifornia | — | $2,672.06 |
| El Centro, CACalifornia | — | $2,674.34 |
| Fresno, CACalifornia | — | $2,672.06 |
| Hanford, CACalifornia | — | $2,672.06 |
| Madera, CACalifornia | — | $2,672.06 |
| Merced, CACalifornia | — | $2,672.06 |
| Modesto, CACalifornia | — | $2,672.06 |
| Napa, CACalifornia | — | $2,879.12 |
| Oxnard, CACalifornia | — | $2,785.26 |
| Redding, CACalifornia | — | $2,672.06 |
| Rest of CaliforniaCalifornia | — | $2,672.06 |
| Riverside, CACalifornia | — | $2,818.19 |
| Sacramento, CACalifornia | — | $2,747.10 |
| Salinas, CACalifornia | — | $2,736.05 |
| San Diego, CACalifornia | — | $2,760.69 |
| Marin County, CACalifornia | — | $2,969.88 |
| San Francisco, CACalifornia | — | $2,954.39 |
| San Benito County, CACalifornia | — | $3,050.88 |
| Santa Clara County, CACalifornia | — | $2,987.55 |
| San Luis Obispo, CACalifornia | — | $2,699.50 |
| Santa Cruz, CACalifornia | — | $2,754.78 |
| Santa Maria, CACalifornia | — | $2,735.42 |
| Santa Rosa, CACalifornia | — | $2,778.37 |
| Stockton, CACalifornia | — | $2,672.06 |
| Vallejo, CACalifornia | — | $2,856.80 |
| Visalia, CACalifornia | — | $2,672.06 |
| Yuba City, CACalifornia | — | $2,672.06 |
| ColoradoColorado | — | $2,754.77 |
| ConnecticutConnecticut | — | $2,972.11 |
| DelawareDelaware | — | $2,748.15 |
| Fort Lauderdale, FLFlorida | — | $3,169.73 |
| Rest of FloridaFlorida | — | $2,994.41 |
| Atlanta, GAGeorgia | — | $2,900.20 |
| Rest of GeorgiaGeorgia | — | $2,811.89 |
| Hawaii, Guam, HIHawaii | — | $2,688.91 |
| IdahoIdaho | — | $2,502.19 |
| East St. Louis, ILIllinois | — | $3,204.25 |
| Rest of IllinoisIllinois | — | $2,994.31 |
| Suburban Chicago, ILIllinois | — | $3,174.15 |
| IndianaIndiana | — | $2,512.57 |
| KansasKansas | — | $2,506.10 |
| KentuckyKentucky | — | $2,683.78 |
| New Orleans, LALouisiana | — | $2,817.64 |
| Rest of LouisianaLouisiana | — | $2,700.82 |
| Metropolitan Boston, MAMassachusetts | — | $2,936.66 |
| Rest of MassachusettsMassachusetts | — | $2,761.84 |
| Baltimore area, MDMaryland | — | $2,975.06 |
| Rest of MarylandMaryland | — | $2,780.61 |
| Rest of MaineMaine | — | $2,570.07 |
| Southern Maine, MEMaine | — | $2,619.46 |
| Detroit, MIMichigan | — | $3,083.52 |
| Rest of MichiganMichigan | — | $2,796.59 |
| MinnesotaMinnesota | — | $2,491.08 |
| Metropolitan Kansas City, MOMissouri | — | $2,743.92 |
| Metropolitan St. Louis, MOMissouri | — | $2,763.61 |
| Rest of MissouriMissouri | — | $2,693.43 |
| MississippiMississippi | — | $2,585.73 |
| MontanaMontana | — | $2,792.41 |
| North CarolinaNorth Carolina | — | $2,586.11 |
| North DakotaNorth Dakota | — | $2,522.70 |
| NebraskaNebraska | — | $2,460.82 |
| New HampshireNew Hampshire | — | $2,762.52 |
| Northern New JerseyNew Jersey | — | $3,033.46 |
| Rest of New JerseyNew Jersey | — | $2,964.19 |
| New MexicoNew Mexico | — | $2,831.94 |
| NevadaNevada | — | $2,717.87 |
| NYC suburbs and Long Island, NYNew York | — | $3,413.12 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $3,026.09 |
| Queens, NYNew York | — | $3,219.58 |
| Rest of New YorkNew York | — | $2,626.11 |
| OhioOhio | — | $2,741.46 |
| OklahomaOklahoma | — | $2,623.46 |
| Portland, OROregon | — | $2,774.70 |
| Rest of OregonOregon | — | $2,655.46 |
| Metropolitan Philadelphia, PAPennsylvania | — | $2,938.00 |
| Rest of PennsylvaniaPennsylvania | — | $2,715.95 |
| Puerto RicoPuerto Rico | — | $2,793.50 |
| Rhode IslandRhode Island | — | $2,797.46 |
| South CarolinaSouth Carolina | — | $2,676.49 |
| South DakotaSouth Dakota | — | $2,490.81 |
| TennesseeTennessee | — | $2,524.33 |
| Austin, TXTexas | — | $2,781.78 |
| Beaumont, TXTexas | — | $2,703.55 |
| Brazoria, TXTexas | — | $2,700.94 |
| Dallas, TXTexas | — | $2,741.37 |
| Fort Worth, TXTexas | — | $2,740.91 |
| Galveston, TXTexas | — | $2,724.09 |
| Houston, TXTexas | — | $2,973.75 |
| Rest of TexasTexas | — | $2,716.59 |
| UtahUtah | — | $2,708.57 |
| VirginiaVirginia | — | $2,648.53 |
| Virgin Islands, VIUnited States Virgin Islands | — | $2,793.50 |
| VermontVermont | — | $2,561.88 |
| Rest of WashingtonWashington | — | $2,740.34 |
| King County, WAWashington | — | $2,939.75 |
| WisconsinWisconsin | — | $2,451.26 |
| West VirginiaWest Virginia | — | $2,906.10 |
| WyomingWyoming | — | $2,674.86 |
47765 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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.
The exact Iowa inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,723
- Code
- 47765
- Physician work
- 50.89
- Practice expense
- 19.10
- Malpractice
- 13.64
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 50.89 | × 1.000 | 50.8900 |
| Practice expense | 19.10 | × 0.915 | 17.4765 |
| Malpractice | 13.64 | × 0.397 | 5.4151 |
| Total RVUs | 73.7816 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$2464.37
Facility: (50.89 × 1 + 19.1 × 0.915 + 13.64 × 0.397) × $33.4009 = $2464.37
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share 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.
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%).
How 47765 has changed in Iowa
47765 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $2,464.37 | RVU26D |
| 2026-07-01 | Not available in this setting | $2,464.37 | RVU26C |
| 2026-04-01 | Not available in this setting | $2,464.37 | RVU26B |
| 2026-01-01 | Not available in this setting | $2,464.37 | RVU26A |
| 2025-10-01 | Not available in this setting | $2,634.74 | RVU25D |
| 2025-07-01 | Not available in this setting | $2,634.74 | RVU25C |
| 2025-04-01 | Not available in this setting | $2,634.74 | RVU25B |
| 2025-01-01 | Not available in this setting | $2,634.74 | RVU25A |
| 2024-10-01 | Not available in this setting | $2,698.33 | RVU24D |
| 2024-07-01 | Not available in this setting | $2,698.33 | RVU24C |
| 2024-04-01 | Not available in this setting | $2,698.33 | RVU24B |
| 2024-03-09 | Not available in this setting | $2,698.33 | RVU24AR |
| 2024-01-01 | Not available in this setting | $2,654.29 | RVU24A |
| 2023-10-01 | Not available in this setting | $2,688.43 | RVU23D |
| 2023-07-01 | Not available in this setting | $2,688.43 | RVU23C |
| 2023-04-01 | Not available in this setting | $2,688.43 | RVU23B |
| 2023-01-01 | Not available in this setting | $2,688.43 | RVU23A |
| 2022-10-01 | Not available in this setting | $2,786.06 | RVU22D |
| 2022-07-01 | Not available in this setting | $2,786.06 | RVU22C |
| 2022-04-01 | Not available in this setting | $2,786.06 | RVU22B |
| 2022-01-01 | Not available in this setting | $2,786.06 | RVU22A |
| 2021-10-01 | Not available in this setting | $2,796.90 | RVU21D |
| 2021-07-01 | Not available in this setting | $2,796.90 | RVU21C |
| 2021-04-01 | Not available in this setting | $2,796.90 | RVU21B |
| 2021-01-01 | Not available in this setting | $2,796.90 | RVU21A |
| 2020-10-01 | Not available in this setting | $2,858.63 | RVU20D |
| 2020-07-01 | Not available in this setting | $2,858.63 | RVU20C |
| 2020-04-01 | Not available in this setting | $2,858.63 | RVU20B |
| 2020-01-01 | Not available in this setting | $2,858.63 | RVU20A |
| 2019-10-01 | Not available in this setting | $2,842.75 | RVU19D |
| 2019-07-01 | Not available in this setting | $2,842.75 | RVU19C |
| 2019-04-01 | Not available in this setting | $2,835.89 | RVU19B |
| 2019-01-01 | Not available in this setting | $2,835.89 | RVU19A |
| 2018-10-01 | Not available in this setting | $2,833.91 | RVU18D |
| 2018-07-01 | Not available in this setting | $2,833.91 | RVU18C |
| 2018-04-01 | Not available in this setting | $2,833.91 | RVU18B |
| 2018-01-01 | Not available in this setting | $2,833.91 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $2,837.28 | RVU17D |
| 2017-07-01 | Not available in this setting | $2,837.28 | RVU17C |
| 2017-04-01 | Not available in this setting | $2,837.28 | RVU17B |
| 2017-01-01 | Not available in this setting | $2,837.28 | RVU17A |
| 2016-10-01 | Not available in this setting | $2,839.65 | RVU16D |
| 2016-07-01 | Not available in this setting | $2,839.65 | RVU16C |
| 2016-04-01 | Not available in this setting | $2,839.65 | RVU16B |
| 2016-01-01 | Not available in this setting | $2,839.65 | RVU16A |
| 2015-10-01 | Not available in this setting | $2,851.03 | RVU15D |
| 2015-07-01 | Not available in this setting | $2,851.03 | RVU15C |
| 2015-04-01 | Not available in this setting | $2,836.84 | RVU15B |
| 2015-01-01 | Not available in this setting | $2,836.84 | RVU15A |
| 2014-10-01 | Not available in this setting | $2,805.71 | RVU14D |
| 2014-07-01 | Not available in this setting | $2,805.71 | RVU14C |
| 2014-04-01 | Not available in this setting | $2,805.71 | RVU14B |
| 2014-01-01 | Not available in this setting | $2,805.71 | RVU14A |
| 2013-10-01 | Not available in this setting | $2,737.80 | RVU13D |
| 2013-07-01 | Not available in this setting | $2,737.80 | RVU13C |
| 2013-04-01 | Not available in this setting | $2,737.80 | RVU13B |
| 2013-01-01 | Not available in this setting | $2,737.80 | RVU13AR |
Where the Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
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
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