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CPT code 47425: Bile duct surgery2026 Medicare rate & RVUs

Reports open incision of the common bile duct to extract a calculus when operative treatment requires direct access to the duct.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,284.60 for 47425 nationally in a facility.

Medicare rate · 47425

Bile duct surgery

Work RVUs
21.75
Total RVUs
38.46
Global days
090

National rate · 2026

$1,284.60

Facility setting, before claim adjustments.

See every locality for 47425 →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 47425 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 47425 covers

Code 47425 represents open choledochotomy to remove a calculus from the common bile duct. The surgeon exposes the extrahepatic duct, incises its wall, and extracts the stone. The procedure is performed by a surgeon in an operating room when open duct surgery is needed for stone removal. It is distinct from an incision of the gallbladder or duct exploration without calculus removal.

Report the code when the operative note supports an incision into the bile duct and extraction of a calculus; documentation should identify the duct and describe the removal. Do not separately report overlapping duct work when a combined cholecystectomy and common-duct procedure describes the operation performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In same-session multiple procedures, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this single-duct service. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team-surgery payment 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 47425 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

47425 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,154.76
Alaska*Unavailable$1,584.19
ArizonaUnavailable$1,245.33
ArkansasUnavailable$1,139.03
AtlantaUnavailable$1,331.67
AustinUnavailable$1,284.99
BakersfieldUnavailable$1,257.31
Baltimore/Surr. CntysUnavailable$1,368.85
BeaumontUnavailable$1,238.06
BrazoriaUnavailable$1,244.37

47425 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
47425 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 47425 rate is calculated

Each of 47425’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 · 47425

RVUs × geographic indexes × conversion factor

Work21.75

21.75 RVUs× 1.000 GPCI

Practice expense10.89

10.89 RVUs× 1.000 GPCI

Malpractice5.82

5.82 RVUs× 1.000 GPCI

Adjusted RVUs

38.4600

Conversion factor

$33.4009

Medicare rate

$1,284.60

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

Payment rules and modifiers for 47425

47425 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 47425

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 · 47425

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.

  • 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

47425 without 51 · national facility

$1,284.60

Bile duct surgery

47425-51 · Second procedure: 50%

$642.30

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

47425 compared with similar codes

Compare codes · National

5 codes, side by side

  • 47425

    Bile duct surgery21.75 wRVU

    Not priced

  • 47420

    Bile duct surgery21.48 wRVU

    Not priced

  • 47610

    Gallbladder surgery20.4 wRVU

    Not priced

  • 47564

    Laparoscopic cholecystectomy17.55 wRVU

    Not priced

  • 43264

    ERCP extraction6.46 wRVU

    Not priced

How to choose

47420Bile duct surgery
Choose 47425 when a calculus is extracted through the bile-duct incision. Choose 47420 for duct exploration without calculus removal as the defining work.
47610Gallbladder surgery
Code 47610 describes an open cholecystectomy combined with common-duct exploration. Code 47425 describes open duct incision with calculus removal, not the combined gallbladder operation.
47564Laparoscopic cholecystectomy
Code 47564 is for laparoscopic cholecystectomy with common-duct exploration. Code 47425 represents open choledochotomy with calculus extraction.
43264ERCP extraction
Code 43264 is used for endoscopic biliary calculus removal during ERCP; 47425 is for open surgical removal through a bile-duct incision.

Codes related to 47425

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

Codes related to 47425
CodeHow it relatesNational office range
Same family
47420Bile duct surgeryCommon bile duct exploration without calculus removal as the defining service.No office rate
Used instead
47610Gallbladder surgeryDescribes open cholecystectomy combined with common-duct exploration.No office rate
47564Laparoscopic cholecystectomyLaparoscopic cholecystectomy with common-duct exploration, rather than open duct incision.No office rate
43264ERCP extractionEndoscopic removal of a biliary calculus through ERCP rather than open duct surgery.No office rate

47425 billing questions

How does 47425 differ from 47420?

Use 47425 when the surgeon incises the common bile duct and removes a calculus. Code 47420 describes duct exploration without calculus removal as the defining service.

Can 47425 be reported with a cholecystectomy?

A cholecystectomy may occur during the same operation, but do not separately report duct work that is included in a combined cholecystectomy and common-duct procedure code.

Is modifier 50 appropriate?

No. This is a single bile-duct service, not a bilateral procedure; modifier 50 is inappropriate.

What documentation supports 47425?

The operative report should establish that the surgeon made an incision in the bile duct and removed a calculus. Duct exploration alone does not support this code.

How are assistants and co-surgeons handled?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team-surgery payment 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 47425PPRRVU2026_Oct_nonQPP.csv, line 5,679 (RVU26D)

Open CMS sourceHow we calculate rates

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