No office rate
Choose 47400 for an incision into a duct within the liver. Code 47420 concerns an extrahepatic bile duct.
On this page
CMS RVU26D · Effective 2026-10-01
47400 Liver duct incision Medicare reimbursement rates in Iowa
Reports an operative incision into an intrahepatic bile duct to explore, drain, or remove a calculus during hepatobiliary surgery. Compare 47400 office and facility rates across CMS payment localities in Iowa.
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 47400 in Iowa?
Iowa 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
$1760.38
1 of 1 localities have a supported rate.
Payment area: Iowa
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.
Hepatobiliary surgery
About 47400: Intrahepatic bile duct incision
Reports an operative incision into an intrahepatic bile duct to explore, drain, or remove a calculus during hepatobiliary surgery.
This code represents an operative incision into a bile duct within the liver, typically to investigate or treat an intrahepatic duct problem such as a calculus or obstruction. A general or hepatobiliary surgeon performs the procedure in an operating room, commonly during open abdominal surgery. The operative report should identify the duct entered and describe the purpose and work performed, such as exploration, drainage, or calculus removal.
Choose this code when the incision is in an intrahepatic duct, rather than the extrahepatic bile duct or gallbladder. The 90-day global period includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and applies a 50% reduction to the others. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this service.
CMS billing rules for 47400
- 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 RVU35.45 · 59%
- Practice expense (office) RVU14.74 · 25%
- Malpractice RVU9.49 · 16%
20
Medicare services in 2024 · #5923 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.
47400 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
Code 47425 addresses an extrahepatic bile duct procedure; 47400 is selected when the operative incision is intrahepatic.
No office rate
Code 47460 is directed at the biliary sphincter. Use 47400 when the surgeon incises an intrahepatic duct instead.
Compare 47400 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
Iowa →
Office / nonfacility
Unavailable
Facility
$1760.38
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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 47400 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
5,677
- Code
- 47400
- Physician work
- 35.45
- Practice expense
- 14.74
- Malpractice
- 9.49
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 35.45 | × 1.000 | 35.4500 |
| Practice expense | 14.74 | × 0.915 | 13.4871 |
| Malpractice | 9.49 | × 0.397 | 3.7675 |
| Total RVUs | 52.7046 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$1760.38
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 35.45 | 1 |
| Practice expense | 14.74 | 0.915 |
| Malpractice | 9.49 | 0.397 |
(35.45 × 1 + 14.74 × 0.915 + 9.49 × 0.397) × $33.4009 = $1760.38
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.
47400 billing questions
How does 47400 differ from 47420 or 47425?
Use 47400 when the operative incision is into an intrahepatic duct. Codes 47420 and 47425 concern an extrahepatic bile duct; the operative purpose and work distinguish those codes from one another.
When is 47400 preferable to a gallbladder incision code?
The target anatomy controls: 47400 concerns a duct within the liver, while 47480 and 47490 concern an incision involving the gallbladder.
Can modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
How does Medicare handle 47400 with another procedure in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.
What documentation supports reporting 47400?
The operative report should specify that the surgeon entered an intrahepatic duct and describe the operative objective and work, such as exploration, drainage, or calculus removal.
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.
5,67447383,,Perq abltj lvr cryoablation,A,,8.66,164.56,,2.29,,1.12,174.34,12.07,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,67547384,,Abltj ire liver 1+ tum perq,A,,9.41,2.17,NA,2.17,,1.12,12.70,12.70,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,67647399,,Unlisted procedure liver,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,67747400,,Incision of liver duct,A,,35.45,14.74,NA,14.74,,9.49,59.68,59.68,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,67847420,,Incision of bile duct,A,,21.48,10.23,NA,10.23,,5.38,37.09,37.09,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,67947425,,Incision of bile duct,A,,21.75,10.89,NA,10.89,,5.82,38.46,38.46,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,68047460,,Incise bile duct sphincter,A,,20.01,10.46,NA,10.46,,5.34,35.81,35.81,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136