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Billing code 47420: Bile duct surgeryMedicare rate & RVUs

Reports operative incision of the bile duct for direct exploration, commonly when a surgeon evaluates suspected obstruction during abdominal surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities189 Medicare services in 2024

Medicare pays $1,238.84 for 47420 nationally in a facility.

Medicare rate · 47420

Bile duct surgery

Swap in your local Medicare rate.

Work RVUs
21.48
Total RVUs
37.09
Global days
090

National rate · 2026

$1,238.84

Facility setting, before claim adjustments.

See every locality for 47420 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 47420 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 47420 covers

This service involves surgically opening the bile duct so the surgeon can inspect or explore its lumen, often to investigate suspected stones or another obstruction. It is typically performed by a general or hepatobiliary surgeon in a hospital operating room as part of an abdominal operation. It is distinct from opening the gallbladder and from endoscopic treatment through the papilla.

Report the code when the operative note supports an actual bile-duct incision and exploration. Documentation should identify the duct involved, the reason for exploration, and the operative work performed; a note describing only gallbladder surgery or endoscopic duct treatment does not support this service. Medicare assigns 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 the others at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this single-duct procedure.

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 47420 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

47420 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,118.14
Alaska*Unavailable$1,539.09
ArizonaUnavailable$1,202.37
ArkansasUnavailable$1,103.51
AtlantaUnavailable$1,282.58
AustinUnavailable$1,239.61
BakersfieldUnavailable$1,215.01
Baltimore/Surr. CntysUnavailable$1,317.85
BeaumontUnavailable$1,195.33
BrazoriaUnavailable$1,201.97

47420 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
47420 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 47420 rate is calculated

Each of 47420’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 · 47420

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 21.48Practice expense 10.23Malpractice 5.38

37.0900 adjusted RVUs×$33.4009 conversion factor=$1,238.84

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 47420

47420 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 47420

Bile duct surgery

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 · 47420

Bile duct surgery

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

47420 without 51 · national facility

$1,238.84

Bile duct surgery

47420-51 · Second procedure: 50%

$619.42

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

47420 compared with similar codes

Compare codes

47420 vs 47425 vs 47400 vs 47460: national Medicare rates

Swap in your local Medicare rate.

  • 47420
    Bile duct surgery · 21.48 wRVU
    —
  • 47425
    Bile duct surgery · 21.75 wRVU
    —
  • 47400
    Liver duct incision · 35.45 wRVU
    —
  • 47460
    Biliary sphincterotomy · 20.01 wRVU
    —

How to choose

47425Bile duct surgery
Choose 47420 for bile-duct incision with exploration. Choose 47425 when the operative service includes removal of a calculus.
47400Liver duct incision
47400 concerns hepatic ducts within the liver; 47420 concerns the bile duct outside the liver.
47460Biliary sphincterotomy
47460 addresses incision or treatment of the biliary sphincter. This code is for an operative incision into the bile duct for exploration.

Codes related to 47420

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

Codes related to 47420
CodeHow it relatesNational office range
Same family
47425Bile duct surgeryRelated bile-duct incision variant for an operative service that includes calculus removal.No office rate
Used instead
47400Liver duct incisionUsed for incision and exploration involving hepatic ducts within the liver rather than the extrahepatic bile duct.No office rate
47460Biliary sphincterotomyAddresses operative treatment at the biliary sphincter rather than incision and exploration of the duct itself.No office rate

47420 billing questions

How is this distinguished from 47425?

This code describes bile-duct incision with exploration. Code 47425 is the related variant used when the documented operative service includes removal of a calculus.

Can this be reported for an endoscopic duct procedure?

No. This code represents operative incision and exploration of the bile duct, not endoscopic treatment such as an incision at the biliary sphincter.

What documentation supports reporting it?

The operative report should identify the bile duct opened, the reason for exploration, and the exploration performed. A general reference to biliary evaluation without an incision and exploration is not enough.

What postoperative care is included?

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

How are multiple procedures and surgical assistance handled?

In the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. An assistant may be paid; co-surgeon payment needs supporting documentation, while team surgery is not permitted.

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 47420PPRRVU2026_Oct_nonQPP.csv, line 5,678 (RVU26D)

Open CMS sourceHow we calculate rates

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