CPT code 47785: Biliary-enteric anastomosis, bile duct to bowel2026 Medicare rate & RVUs in Missouri
Reports surgical reconstruction connecting a bile duct to the bowel to provide bile drainage when the usual route is obstructed or disrupted.
CMS doesn’t publish an office rate for 47785 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 47785 covers
The surgeon creates a connection between a bile duct and a segment of bowel so bile can drain into the digestive tract. This reconstruction may be performed during abdominal surgery when the normal biliary pathway cannot provide adequate drainage. The operative report should identify the duct and bowel involved and describe the anastomosis; the code is not for connecting the gallbladder to bowel or simply exploring a duct.
Report 47785 for the biliary-to-bowel reconstruction supported by the operative details, distinguishing it from neighboring codes by the anatomy and technique documented. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this service. 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 47785 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $2,920.47 |
| Metropolitan St. Louis, MO | Unavailable | $2,940.95 |
| Rest of Missouri | Unavailable | $2,867.19 |
How the 47785 rate is calculated
Each of 47785’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 · 47785
RVUs × geographic indexes × conversion factor
Work54.79
54.79 RVUs× 1.000 GPCI
Practice expense20.17
20.17 RVUs× 1.000 GPCI
Malpractice14.03
14.03 RVUs× 1.000 GPCI
Adjusted RVUs
88.9900
Conversion factor
$33.4009
Medicare rate
$2,972.35
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 47785
47785 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 47785
Biliary-enteric anastomosis, bile duct to bowel
| 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 · 47785
Biliary-enteric anastomosis, bile duct to bowel
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
47785 without 51 · national facility
$2,972.35
Biliary-enteric anastomosis, bile duct to bowel
47785-51 · Second procedure: 50%
$1,486.18
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%).
47785 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 47760Biliary bypassCholedochoenterostomy
- Both describe biliary-enteric reconstruction. Choose between them using the specific anatomy and procedure documented in the operative report, not merely the shared drainage goal.
- 47765Biliary bypassExtrahepatic duct, intestinal transposition
- 47765 is identified for reconstruction involving liver ducts and bowel. Use 47785 only when the documented procedure matches its specific bile duct-to-bowel code description.
- 47720Biliary bypassGallbladder to bowel
- 47720 connects the gallbladder to the gastrointestinal tract; 47785 is for a connection involving a bile duct.
47785 billing questions
How is 47785 distinguished from other bile duct-to-bowel codes?
Use the operative report to identify the duct, bowel, and reconstruction performed, then match those details to the specific code description. Codes in this group are not interchangeable based only on the fact that bile drains into bowel.
Can gallbladder-to-bowel reconstruction be reported with 47785?
No. 47785 describes a bile duct-to-bowel reconstruction; gallbladder-to-bowel procedures are represented by different codes, such as 47720.
Is modifier 50 appropriate for 47785?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor and anatomy.
What postoperative care is included?
The 90-day 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 made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other same-session procedures paid?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure 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
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