Billing code 47780: Biliary reconstructionMedicare rate & RVUs in Massachusetts
Reports reconstruction connecting an extrahepatic bile duct to the gastrointestinal tract using a Roux-en-Y configuration, typically for biliary obstruction or duct injury.
CMS doesn’t publish an office rate for 47780 in Massachusetts.
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 47780 covers
This operation joins an extrahepatic bile duct to the gastrointestinal tract in a Roux-en-Y reconstruction, commonly connecting the duct to a jejunal limb to restore bile drainage. A hepatobiliary or general surgeon typically performs it in the operating room when the duct requires definitive reconstruction, such as after injury, excision, or treatment of an obstructing condition. The operative report should identify the duct and bowel used and describe the Roux-en-Y configuration.
Report the code when the documented reconstruction matches the extrahepatic duct and Roux-en-Y service, rather than a simpler biliary-enteric anastomosis or an anastomosis involving intrahepatic ducts. The code has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. 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% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require 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 47780 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | Unavailable | $2,408.67 |
| Rest Of Massachusetts | Unavailable | $2,263.45 |
How the 47780 rate is calculated
Each of 47780’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 · 47780
RVUs × geographic indexes × conversion factor
Work41.26
41.26 RVUs× 1.000 GPCI
Practice expense16.56
16.56 RVUs× 1.000 GPCI
Malpractice10.55
10.55 RVUs× 1.000 GPCI
Adjusted RVUs
68.3700
Conversion factor
$33.4009
Medicare rate
$2,283.62
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 47780
47780 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 47780
Biliary reconstruction
| 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 · 47780
Biliary reconstruction
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
47780 without 51 · national facility
$2,283.62
Biliary reconstruction
47780-51 · Second procedure: 50%
$1,141.81
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%).
47780 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 47760Biliary bypass
- Both address an extrahepatic biliary-enteric connection. Use 47780 when the operative report documents the Roux-en-Y configuration; 47760 represents the related service without that distinction.
- 47765Biliary bypass
- 47765 involves intrahepatic ducts rather than the extrahepatic duct anatomy covered by 47780. Let the documented site of the duct connection guide selection.
- 47701Bile duct revision
- 47701 is for revising a biliary anastomosis that already exists. 47780 reports the specified Roux-en-Y reconstruction, not revision alone.
47780 billing questions
How does this differ from 47760?
47780 is for the extrahepatic biliary-enteric reconstruction with a Roux-en-Y configuration. Use 47760 when the documented anastomosis does not meet that specific reconstruction description.
When is 47765 a better fit?
47765 describes an anastomosis involving intrahepatic bile ducts and the gastrointestinal tract. Select based on the duct anatomy documented in the operative report.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day 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-surgeons are paid only with supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a 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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