47143
No office ratePrep donor liver whole
47143 covers backbench preparation of a whole donor liver graft. Use 47146 for venous anastomosis work performed on the graft.
On this page
CMS RVU26D · Effective 2026-10-01
47146 Graft preparation Medicare reimbursement rates in Alabama
A transplant surgeon reports donor-liver backbench reconstruction for each venous connection created to establish graft outflow before liver implantation. Compare 47146 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 47146 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$266.39
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Transplant surgery
About 47146: Donor liver venous reconstruction
A transplant surgeon reports donor-liver backbench reconstruction for each venous connection created to establish graft outflow before liver implantation.
A transplant surgeon reconstructs venous outflow on a donor liver graft on the back table before implantation. The work may involve joining or shaping graft veins to create a usable outflow pathway. It is distinct from removing the donor liver and implanting the graft in the recipient. This work is performed in the operating room during preparation of a graft from a deceased or living donor.
Report one unit for each venous anastomosis performed. The operative report should identify the graft, the veins joined, the number of reconstructions, and the work performed. When other procedures occur during the same session, CMS applies the standard multiple-procedure reduction: the highest-valued procedure is paid in full, and the other procedures are paid at 50%.
CMS billing rules for 47146
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Where the value comes from
- Work RVU5.85 · 66%
- Practice expense (office) RVU1.42 · 16%
- Malpractice RVU1.56 · 18%
171
Medicare services in 2024 · #4470 by national volume
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.
47146 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
47147 identifies arterial reconstruction on the donor graft; 47146 identifies venous reconstruction.
47135
No office rateTransplantation of liver
47135 covers placing the donor liver in the recipient. Code 47146 covers venous reconstruction of the graft before implantation.
Compare 47146 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$266.39
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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 47146 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
5,661
- Code
- 47146
- Physician work
- 5.85
- Practice expense
- 1.42
- Malpractice
- 1.56
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.85 | × 1.000 | 5.8500 |
| Practice expense | 1.42 | × 0.875 | 1.2425 |
| Malpractice | 1.56 | × 0.566 | 0.8830 |
| Total RVUs | 7.9755 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$266.39
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.85 | 1 |
| Practice expense | 1.42 | 0.875 |
| Malpractice | 1.56 | 0.566 |
(5.85 × 1 + 1.42 × 0.875 + 1.56 × 0.566) × $33.4009 = $266.39
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.
47146 billing questions
How does this differ from whole-graft preparation?
Code 47143 describes backbench preparation of a whole donor liver. Code 47146 identifies venous reconstruction work, so the record should show that this work was performed.
How many units should be reported?
Report one unit for each venous anastomosis performed. Document the number of reconstructed venous connections in the operative report.
Can this be reported with liver transplantation?
The backbench reconstruction occurs before implantation, while 47135 describes transplantation in the recipient. The operative record should support each service performed.
What documentation supports reporting this code?
Document the donor graft, the veins reconstructed, the anastomosis work, and the number of connections. A general statement that the graft was prepared does not identify the venous reconstruction.
How does the multiple-procedure payment rule affect this service?
When other procedures are performed in the same session, CMS pays the highest-valued procedure in full and pays the other procedures at 50%.
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.
5,65847143,,Prep donor liver whole,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,65947144,,Prep donor liver 3-segment,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,66047145,,Prep donor liver lobe split,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,66147146,,Prep donor liver/venous,A,,5.85,1.42,NA,1.42,,1.56,8.83,8.83,0,XXX,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,66247147,,Prep donor liver/arterial,A,,6.83,1.67,NA,1.67,,1.79,10.29,10.29,0,XXX,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,66347300,,Surgery for liver lesion,A,,17.69,9.92,NA,9.92,,4.51,32.12,32.12,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,66447350,,Repair liver wound,A,,21.93,11.22,NA,11.22,,5.34,38.49,38.49,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515