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Billing code 47720: Biliary bypassMedicare rate & RVUs

A surgeon creates a drainage connection from the gallbladder to bowel to bypass biliary obstruction when the gallbladder can provide a viable drainage route.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,096.22 for 47720 nationally in a facility.

Medicare rate · 47720

Biliary bypass

Swap in your local Medicare rate.

Work RVUs
17.88
Total RVUs
32.82
Global days
090

National rate · 2026

$1,096.22

Facility setting, before claim adjustments.

See every locality for 47720 → · 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 47720 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 47720 covers

The surgeon connects the gallbladder to an intestinal segment to provide another route for bile drainage. This operation may be considered when an obstruction prevents bile from reaching the intestine through the usual duct pathway and the gallbladder can serve as the source of drainage. It is performed in an operating room by a surgeon, commonly as bypass surgery for biliary obstruction. The operative report should identify the gallbladder and bowel as the structures joined and describe the reason for the bypass.

Report this code when the documented operation creates that gallbladder-to-bowel connection; a connection from a bile duct or liver duct to bowel is a different service. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global 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 inappropriate for this anatomy. An assistant at surgery may be paid; 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 47720 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

47720 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$984.51
Alaska*Unavailable$1,345.19
ArizonaUnavailable$1,062.71
ArkansasUnavailable$970.94
AtlantaUnavailable$1,135.53
AustinUnavailable$1,098.89
BakersfieldUnavailable$1,077.72
Baltimore/Surr. CntysUnavailable$1,168.38
BeaumontUnavailable$1,054.34
BrazoriaUnavailable$1,062.82

47720 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
47720 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 47720 rate is calculated

Each of 47720’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 · 47720

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 17.88Practice expense 10.16Malpractice 4.78

32.8200 adjusted RVUs×$33.4009 conversion factor=$1,096.22

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

Payment rules and modifiers for 47720

47720 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 47720

Biliary bypass

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 · 47720

Biliary bypass

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

47720 without 51 · national facility

$1,096.22

Biliary bypass

47720-51 · Second procedure: 50%

$548.11

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

47720 compared with similar codes

Compare codes

47720 vs 47740 vs 47760 vs 47765: national Medicare rates

Swap in your local Medicare rate.

  • 47720
    Biliary bypass · 17.88 wRVU
    —
  • 47740
    Biliary bypass · 20.7 wRVU
    —
  • 47760
    Biliary bypass · 37.36 wRVU
    —
  • 47765
    Biliary bypass · 50.89 wRVU
    —

How to choose

47740Biliary bypass
Both involve a gallbladder-to-bowel bypass. Use the code that matches the specific operative service and any additional work documented.
47760Biliary bypass
This code is for a connection from the gallbladder to bowel; 47760 is used when the common bile duct is joined to bowel.
47765Biliary bypass
This code uses the gallbladder as the drainage source. 47765 describes a bypass originating from a liver duct.

Codes related to 47720

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

Codes related to 47720
CodeHow it relatesNational office range
Same family
47740Biliary bypassRelated gallbladder-to-bowel bypass code; select based on the documented operative service.No office rate
47741Biliary bypassRelated gallbladder-to-bowel bypass code; review the operative details to distinguish the service.No office rate
Used instead
47760Biliary bypassConnects the common bile duct to bowel rather than using the gallbladder as the drainage source.No office rate
47765Biliary bypassConnects a liver duct to bowel when the operative bypass originates at the hepatic duct.No office rate

47720 billing questions

How do I distinguish this from a bile-duct-to-bowel bypass?

Check which structures the surgeon joined. This code describes a connection from the gallbladder to bowel; a connection from the common bile duct or a liver duct to bowel is a different procedure.

What operative documentation supports this code?

The report should identify the gallbladder and intestinal segment joined, describe the anastomosis, and explain the biliary drainage problem the bypass addresses.

Should modifier 50 be appended?

No. The anatomy and service are not bilateral for Medicare payment purposes, so modifier 50 is inappropriate.

How are related postoperative visits handled?

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

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; 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 47720PPRRVU2026_Oct_nonQPP.csv, line 5,718 (RVU26D)

Open CMS sourceHow we calculate rates

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