Billing code 47425: Bile duct surgeryMedicare rate & RVUs in Illinois
Reports open incision of the common bile duct to extract a calculus when operative treatment requires direct access to the duct.
CMS doesn’t publish an office rate for 47425 in Illinois.
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 9 sections
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 in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,543.24 |
| East St. Louis | Unavailable | $1,452.61 |
| Rest Of Illinois | Unavailable | $1,362.40 |
| Suburban Chicago | Unavailable | $1,449.58 |
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
Swap in your local Medicare rate.
Work 21.75Practice expense 10.89Malpractice 5.82
All indexes start 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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share 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.
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%).
47425 compared with similar codes
Compare codes
47425 vs 47420 vs 47610 vs 47564 vs 43264: national Medicare rates
Swap in your local Medicare rate.
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.
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
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