Billing code 47765: Biliary bypassMedicare rate & RVUs in Illinois
Reports an extrahepatic bile duct-to-intestine connection with intestinal transposition, typically used to restore bile drainage when the usual route is obstructed or disrupted.
CMS doesn’t publish an office rate for 47765 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 47765 covers
This operation creates a route for bile from an extrahepatic duct into the gastrointestinal tract, using a transposed segment of intestine, commonly as a Roux-en-Y limb. A hepatobiliary or general surgeon may perform it for selected biliary obstruction, injury, or reconstruction when the affected duct and operative plan call for this type of bypass. The operative report should identify the duct used, the intestinal segment and reconstruction, and the completed anastomosis.
Select this code when the documented operation includes extrahepatic duct-to-bowel anastomosis with intestinal transposition; a direct anastomosis or an intrahepatic duct connection points to a different family code. This is major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care during that 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 not appropriate for this anatomy. Assistant-at-surgery payment may be available; 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 47765 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 | $3,398.39 |
| East St. Louis | Unavailable | $3,204.25 |
| Rest Of Illinois | Unavailable | $2,994.31 |
| Suburban Chicago | Unavailable | $3,174.15 |
How the 47765 rate is calculated
Each of 47765’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 · 47765
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 50.89Practice expense 19.10Malpractice 13.64
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 47765
47765 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 47765
Biliary bypass
| 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 · 47765
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
47765 without 51 · national facility
$2,793.32
Biliary bypass
47765-51 · Second procedure: 50%
$1,396.66
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%).
47765 compared with similar codes
Compare codes
47765 vs 47760 vs 47780 vs 47720 vs 47721: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 47760Biliary bypass
- Both involve extrahepatic biliary ducts and the gastrointestinal tract. Use 47765 when intestinal transposition is part of the reconstruction; 47760 describes the related anastomosis without it.
- 47780Biliary reconstruction
- 47780 involves intrahepatic ducts, whereas 47765 is for an extrahepatic duct connection with intestinal transposition.
- 47720Biliary bypass
- 47720 connects the common bile duct directly to intestine. Select 47765 when the operation instead uses the extrahepatic biliary reconstruction with intestinal transposition.
- 47721Combined bypass
- 47721 describes a common bile duct-to-intestine Roux-en-Y reconstruction; 47765 represents the extrahepatic duct reconstruction with intestinal transposition.
47765 billing questions
How does this differ from 47760?
47765 includes intestinal transposition in the extrahepatic duct-to-gastrointestinal tract reconstruction. Use 47760 for the related anastomosis without that transposition.
When would 47780 or 47785 be more appropriate?
Those codes describe connections involving intrahepatic ducts. Choose the code that matches the duct location and reconstruction documented in the operative report.
Is modifier 50 appropriate?
No. The anatomy and service are not reported as bilateral, so modifier 50 is inappropriate.
What is included in the global period?
The major-surgery 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 available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
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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