No office rate
47720 describes a gallbladder-to-bowel bypass without the combined stomach-to-bowel connection. Choose 47721 when both anastomoses are performed.
On this page
CMS RVU26D · Effective 2026-10-01
47721 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1255.74
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Biliary surgery
About 47721: Cholecystoenterostomy with gastroenterostomy
A combined bypass connecting the gallbladder and stomach to intestine, reported when both anastomoses are created during the same operation.
This operation creates two intestinal connections: one from the gallbladder to the bowel to divert bile, and another from the stomach to the bowel to bypass an obstruction. It may be used in abdominal surgery when both biliary drainage and passage of stomach contents need surgical bypass, such as in selected patients with advanced pancreatic or periampullary disease. The surgeon’s operative report should establish that both connections were performed and identify the anatomy used.
Report the combined service when the operation includes both the gallbladder-to-bowel and stomach-to-bowel anastomoses. The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 47721
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU21.44 · 56%
- Practice expense (office) RVU11.03 · 29%
- Malpractice RVU5.73 · 15%
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.
47721 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
47740 is another gallbladder-to-bowel bypass code. Select based on the specific operation documented, not simply because the patient has biliary obstruction.
No office rate
47760 connects the bile duct to bowel; this code includes a gallbladder-to-bowel connection together with a stomach-to-bowel bypass.
The same code, a different location
How does Delaware compare?
47721 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 47721
Office
Unavailable
Facility
$1146.80
No comparable office rate is available.
Arkansas
Arkansas · 47721
Office
Unavailable
Facility
$1131.15
No comparable office rate is available.
Arizona
Arizona · 47721
Office
Unavailable
Facility
$1236.93
No comparable office rate is available.
Bakersfield
California · 47721
Office
Unavailable
Facility
$1250.06
No comparable office rate is available.
Chico
California · 47721
Office
Unavailable
Facility
$1234.65
No comparable office rate is available.
El Centro
California · 47721
Office
Unavailable
Facility
$1235.61
No comparable office rate is available.
Fresno
California · 47721
Office
Unavailable
Facility
$1234.65
No comparable office rate is available.
Hanford-Corcoran
California · 47721
Office
Unavailable
Facility
$1234.65
No comparable office rate is available.
Madera
California · 47721
Office
Unavailable
Facility
$1234.65
No comparable office rate is available.
Merced
California · 47721
Office
Unavailable
Facility
$1234.65
No comparable office rate is available.
Modesto
California · 47721
Office
Unavailable
Facility
$1234.65
No comparable office rate is available.
Napa
California · 47721
Office
Unavailable
Facility
$1344.02
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 47721
Office
Unavailable
Facility
$1290.86
No comparable office rate is available.
Redding
California · 47721
Office
Unavailable
Facility
$1234.65
No comparable office rate is available.
Rest Of California
California · 47721
Office
Unavailable
Facility
$1234.65
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 47721
Office
Unavailable
Facility
$1296.04
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 47721
Office
Unavailable
Facility
$1272.94
No comparable office rate is available.
Salinas
California · 47721
Office
Unavailable
Facility
$1267.89
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 47721
Office
Unavailable
Facility
$1281.95
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 47721
Office
Unavailable
Facility
$1391.45
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 47721
Office
Unavailable
Facility
$1384.95
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 47721
Office
Unavailable
Facility
$1428.72
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 47721
Office
Unavailable
Facility
$1402.12
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 47721
Office
Unavailable
Facility
$1250.49
No comparable office rate is available.
Santa Cruz-Watsonville
California · 47721
Office
Unavailable
Facility
$1281.36
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 47721
Office
Unavailable
Facility
$1268.32
No comparable office rate is available.
Santa Rosa-Petaluma
California · 47721
Office
Unavailable
Facility
$1292.59
No comparable office rate is available.
Stockton
California · 47721
Office
Unavailable
Facility
$1234.65
No comparable office rate is available.
Vallejo
California · 47721
Office
Unavailable
Facility
$1334.64
No comparable office rate is available.
Visalia
California · 47721
Office
Unavailable
Facility
$1234.65
No comparable office rate is available.
Yuba City
California · 47721
Office
Unavailable
Facility
$1234.65
No comparable office rate is available.
Colorado
Colorado · 47721
Office
Unavailable
Facility
$1266.17
No comparable office rate is available.
Connecticut
Connecticut · 47721
Office
Unavailable
Facility
$1358.80
No comparable office rate is available.
Fort Lauderdale
Florida · 47721
Office
Unavailable
Facility
$1435.34
No comparable office rate is available.
Rest Of Florida
Florida · 47721
Office
Unavailable
Facility
$1355.97
No comparable office rate is available.
Atlanta
Georgia · 47721
Office
Unavailable
Facility
$1322.43
No comparable office rate is available.
Rest Of Georgia
Georgia · 47721
Office
Unavailable
Facility
$1272.87
No comparable office rate is available.
Hawaii, Guam
Hawaii · 47721
Office
Unavailable
Facility
$1245.81
No comparable office rate is available.
Iowa
Iowa · 47721
Office
Unavailable
Facility
$1129.19
No comparable office rate is available.
Idaho
Idaho · 47721
Office
Unavailable
Facility
$1145.58
No comparable office rate is available.
East St. Louis
Illinois · 47721
Office
Unavailable
Facility
$1440.51
No comparable office rate is available.
Rest Of Illinois
Illinois · 47721
Office
Unavailable
Facility
$1351.61
No comparable office rate is available.
Suburban Chicago
Illinois · 47721
Office
Unavailable
Facility
$1438.63
No comparable office rate is available.
Indiana
Indiana · 47721
Office
Unavailable
Facility
$1150.65
No comparable office rate is available.
Kansas
Kansas · 47721
Office
Unavailable
Facility
$1145.62
No comparable office rate is available.
Kentucky
Kentucky · 47721
Office
Unavailable
Facility
$1218.75
No comparable office rate is available.
New Orleans
Louisiana · 47721
Office
Unavailable
Facility
$1280.21
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 47721
Office
Unavailable
Facility
$1225.51
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 47721
Office
Unavailable
Facility
$1355.69
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 47721
Office
Unavailable
Facility
$1268.05
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 47721
Office
Unavailable
Facility
$1359.63
No comparable office rate is available.
Rest Of Maryland
Maryland · 47721
Office
Unavailable
Facility
$1271.80
No comparable office rate is available.
Rest Of Maine
Maine · 47721
Office
Unavailable
Facility
$1174.10
No comparable office rate is available.
Southern Maine
Maine · 47721
Office
Unavailable
Facility
$1201.98
No comparable office rate is available.
Detroit
Michigan · 47721
Office
Unavailable
Facility
$1394.31
No comparable office rate is available.
Rest Of Michigan
Michigan · 47721
Office
Unavailable
Facility
$1268.55
No comparable office rate is available.
Minnesota
Minnesota · 47721
Office
Unavailable
Facility
$1151.86
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 47721
Office
Unavailable
Facility
$1249.04
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 47721
Office
Unavailable
Facility
$1258.61
No comparable office rate is available.
Rest Of Missouri
Missouri · 47721
Office
Unavailable
Facility
$1220.10
No comparable office rate is available.
Mississippi
Mississippi · 47721
Office
Unavailable
Facility
$1174.75
No comparable office rate is available.
Montana**
Montana · 47721
Office
Unavailable
Facility
$1275.53
No comparable office rate is available.
North Carolina
North Carolina · 47721
Office
Unavailable
Facility
$1182.14
No comparable office rate is available.
North Dakota**
North Dakota · 47721
Office
Unavailable
Facility
$1162.23
No comparable office rate is available.
Nebraska
Nebraska · 47721
Office
Unavailable
Facility
$1128.50
No comparable office rate is available.
New Hampshire
New Hampshire · 47721
Office
Unavailable
Facility
$1267.10
No comparable office rate is available.
Northern Nj
New Jersey · 47721
Office
Unavailable
Facility
$1392.99
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 47721
Office
Unavailable
Facility
$1357.02
No comparable office rate is available.
New Mexico
New Mexico · 47721
Office
Unavailable
Facility
$1283.81
No comparable office rate is available.
Nevada**
Nevada · 47721
Office
Unavailable
Facility
$1244.32
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 47721
Office
Unavailable
Facility
$1555.39
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 47721
Office
Unavailable
Facility
$1383.33
No comparable office rate is available.
Queens
New York · 47721
Office
Unavailable
Facility
$1473.39
No comparable office rate is available.
Rest Of New York
New York · 47721
Office
Unavailable
Facility
$1200.65
No comparable office rate is available.
Ohio
Ohio · 47721
Office
Unavailable
Facility
$1245.39
No comparable office rate is available.
Oklahoma
Oklahoma · 47721
Office
Unavailable
Facility
$1193.81
No comparable office rate is available.
Portland
Oregon · 47721
Office
Unavailable
Facility
$1279.27
No comparable office rate is available.
Rest Of Oregon
Oregon · 47721
Office
Unavailable
Facility
$1217.60
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 47721
Office
Unavailable
Facility
$1340.85
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 47721
Office
Unavailable
Facility
$1235.18
No comparable office rate is available.
Puerto Rico
Puerto Rico · 47721
Office
Unavailable
Facility
$1277.10
No comparable office rate is available.
Rhode Island
Rhode Island · 47721
Office
Unavailable
Facility
$1281.01
No comparable office rate is available.
South Carolina
South Carolina · 47721
Office
Unavailable
Facility
$1219.21
No comparable office rate is available.
South Dakota**
South Dakota · 47721
Office
Unavailable
Facility
$1148.83
No comparable office rate is available.
Tennessee
Tennessee · 47721
Office
Unavailable
Facility
$1153.78
No comparable office rate is available.
Austin
Texas · 47721
Office
Unavailable
Facility
$1276.90
No comparable office rate is available.
Beaumont
Texas · 47721
Office
Unavailable
Facility
$1229.17
No comparable office rate is available.
Brazoria
Texas · 47721
Office
Unavailable
Facility
$1236.22
No comparable office rate is available.
Dallas
Texas · 47721
Office
Unavailable
Facility
$1253.71
No comparable office rate is available.
Fort Worth
Texas · 47721
Office
Unavailable
Facility
$1252.51
No comparable office rate is available.
Galveston
Texas · 47721
Office
Unavailable
Facility
$1246.15
No comparable office rate is available.
Houston
Texas · 47721
Office
Unavailable
Facility
$1351.03
No comparable office rate is available.
Rest Of Texas
Texas · 47721
Office
Unavailable
Facility
$1238.56
No comparable office rate is available.
Utah
Utah · 47721
Office
Unavailable
Facility
$1234.29
No comparable office rate is available.
Virginia
Virginia · 47721
Office
Unavailable
Facility
$1213.38
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 47721
Office
Unavailable
Facility
$1277.10
No comparable office rate is available.
Vermont
Vermont · 47721
Office
Unavailable
Facility
$1177.69
No comparable office rate is available.
Rest Of Washington
Washington · 47721
Office
Unavailable
Facility
$1259.01
No comparable office rate is available.
Seattle (King Cnty)
Washington · 47721
Office
Unavailable
Facility
$1360.33
No comparable office rate is available.
Wisconsin
Wisconsin · 47721
Office
Unavailable
Facility
$1128.00
No comparable office rate is available.
West Virginia
West Virginia · 47721
Office
Unavailable
Facility
$1310.14
No comparable office rate is available.
Wyoming**
Wyoming · 47721
Office
Unavailable
Facility
$1226.15
No comparable office rate is available.
See how rates vary across the country
47721 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Where does this rate apply?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 47721 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1381.31
$1255.74 × 110% = $1381.31
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 47721 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
5,719
- Code
- 47721
- Physician work
- 21.44
- Practice expense
- 11.03
- Malpractice
- 5.73
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.44 | × 1.005 | 21.5472 |
| Practice expense | 11.03 | × 0.988 | 10.8976 |
| Malpractice | 5.73 | × 0.899 | 5.1513 |
| Total RVUs | 37.5961 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$1255.74
Open 47721 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.44 | 1.005 |
| Practice expense | 11.03 | 0.988 |
| Malpractice | 5.73 | 0.899 |
(21.44 × 1.005 + 11.03 × 0.988 + 5.73 × 0.899) × $33.4009 = $1255.74
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
47721 · 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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1255.74 | RVU26D |
| 2026-07-01 | Not available in this setting | $1255.74 | RVU26C |
| 2026-04-01 | Not available in this setting | $1255.74 | RVU26B |
| 2026-01-01 | Not available in this setting | $1255.74 | RVU26A |
| 2025-10-01 | Not available in this setting | $1315.70 | RVU25D |
| 2025-07-01 | Not available in this setting | $1315.70 | RVU25C |
| 2025-04-01 | Not available in this setting | $1315.70 | RVU25B |
| 2025-01-01 | Not available in this setting | $1315.70 | RVU25A |
47721 billing questions
When is this code preferable to 47720?
Use this code when the operation includes both a gallbladder-to-bowel connection and a stomach-to-bowel connection. Code 47720 represents a gallbladder-to-bowel bypass without that combined gastric bypass service.
Can the gastroenterostomy be reported separately?
This code represents the combined operation, including both connections. The operative report should document each anastomosis rather than describing only a biliary bypass.
Should modifier 50 be appended?
No. The anatomy and service represented by this code make bilateral reporting with modifier 50 inappropriate.
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.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,71647712,,Excision of bile duct tumor,A,,32.88,13.80,NA,13.80,,8.80,55.48,55.48,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,71747715,,Excision of bile duct cyst,A,,21.01,10.92,NA,10.92,,5.61,37.54,37.54,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,71847720,,Fuse gallbladder & bowel,A,,17.88,10.16,NA,10.16,,4.78,32.82,32.82,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,71947721,,Fuse upper gi structures,A,,21.44,11.03,NA,11.03,,5.73,38.20,38.20,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,72047740,,Fuse gallbladder & bowel,A,,20.70,10.85,NA,10.85,,5.53,37.08,37.08,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,72147741,,Fuse gallbladder & bowel,A,,23.60,11.55,NA,11.55,,6.31,41.46,41.46,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,72247760,,Fuse bile ducts and bowel,A,,37.36,15.43,NA,15.43,,9.42,62.21,62.21,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503