No office rate
Both involve a gallbladder-to-bowel bypass. Use the code that matches the specific operative service and any additional work documented.
On this page
CMS RVU26D · Effective 2026-10-01
47720 Biliary bypass Medicare reimbursement rates in California
A surgeon creates a drainage connection from the gallbladder to bowel to bypass biliary obstruction when the gallbladder can provide a viable drainage route. Compare 47720 office and facility rates across CMS payment localities in California.
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 47720 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1064.87–$1237.82
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $172.95 per service.
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.
Where 47720 pays more and less in California
Biliary surgery
About 47720: Gallbladder-to-intestine bypass anastomosis
A surgeon creates a drainage connection from the gallbladder to bowel to bypass biliary obstruction when the gallbladder can provide a viable drainage route.
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.
CMS billing rules for 47720
- 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 RVU17.88 · 54%
- Practice expense (office) RVU10.16 · 31%
- Malpractice RVU4.78 · 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.
47720 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
This code is for a connection from the gallbladder to bowel; 47760 is used when the common bile duct is joined to bowel.
No office rate
This code uses the gallbladder as the drainage source. 47765 describes a bypass originating from a liver duct.
Compare 47720 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $1077.72 |
| Chico | Office Unavailable | Facility $1064.87 |
| El Centro | Office Unavailable | Facility $1065.67 |
| Fresno | Office Unavailable | Facility $1064.87 |
| Hanford-Corcoran | Office Unavailable | Facility $1064.87 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1129.16 |
| Madera | Office Unavailable | Facility $1064.87 |
| Merced | Office Unavailable | Facility $1064.87 |
| Modesto | Office Unavailable | Facility $1064.87 |
| Napa | Office Unavailable | Facility $1163.21 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1114.51 |
| Redding | Office Unavailable | Facility $1064.87 |
| Rest Of California | Office Unavailable | Facility $1064.87 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1116.08 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1098.95 |
| Salinas | Office Unavailable | Facility $1094.61 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1107.52 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1205.71 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1200.28 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1237.82 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1215.63 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1079.46 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1107.64 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1095.19 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1117.43 |
| Stockton | Office Unavailable | Facility $1064.87 |
| Vallejo | Office Unavailable | Facility $1155.38 |
| Visalia | Office Unavailable | Facility $1064.87 |
| Yuba City | Office Unavailable | Facility $1064.87 |
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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 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.
5,71547711,,Excision of bile duct tumor,A,,25.25,11.75,NA,11.75,,6.33,43.33,43.33,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,71647712,,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