No office rate
47720 describes a gallbladder-to-bowel bypass without the combined stomach-to-bowel connection. Choose 47721 when both anastomoses are performed.
On this page
CMS RVU26D · Effective 2026-10-01
47721 Combined bypass Medicare reimbursement rates in Nebraska
A combined bypass connecting the gallbladder and stomach to intestine, reported when both anastomoses are created during the same operation. Compare 47721 office and facility rates across CMS payment localities in Nebraska.
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 47721 in Nebraska?
Nebraska 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
$1128.50
1 of 1 localities have a supported rate.
Payment area: Nebraska
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.
Biliary surgery
About 47721: Cholecystoenterostomy with gastroenterostomy
A combined bypass connecting the gallbladder and stomach to intestine, reported when both anastomoses are created during the same operation.
This operation creates two intestinal connections: one from the gallbladder to the bowel to divert bile, and another from the stomach to the bowel to bypass an obstruction. It may be used in abdominal surgery when both biliary drainage and passage of stomach contents need surgical bypass, such as in selected patients with advanced pancreatic or periampullary disease. The surgeon’s operative report should establish that both connections were performed and identify the anatomy used.
Report the combined service when the operation includes both the gallbladder-to-bowel and stomach-to-bowel anastomoses. The major-surgery global period 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 the others at 50%. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 47721
- 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 RVU21.44 · 56%
- Practice expense (office) RVU11.03 · 29%
- Malpractice RVU5.73 · 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.
47721 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
47740 is another gallbladder-to-bowel bypass code. Select based on the specific operation documented, not simply because the patient has biliary obstruction.
No office rate
47760 connects the bile duct to bowel; this code includes a gallbladder-to-bowel connection together with a stomach-to-bowel bypass.
Compare 47721 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$1128.50
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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 47721 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
5,719
- Code
- 47721
- Physician work
- 21.44
- Practice expense
- 11.03
- Malpractice
- 5.73
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.44 | × 1.000 | 21.4400 |
| Practice expense | 11.03 | × 0.923 | 10.1807 |
| Malpractice | 5.73 | × 0.378 | 2.1659 |
| Total RVUs | 33.7866 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$1128.50
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.44 | 1 |
| Practice expense | 11.03 | 0.923 |
| Malpractice | 5.73 | 0.378 |
(21.44 × 1 + 11.03 × 0.923 + 5.73 × 0.378) × $33.4009 = $1128.50
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.
47721 billing questions
When is this code preferable to 47720?
Use this code when the operation includes both a gallbladder-to-bowel connection and a stomach-to-bowel connection. Code 47720 represents a gallbladder-to-bowel bypass without that combined gastric bypass service.
Can the gastroenterostomy be reported separately?
This code represents the combined operation, including both connections. The operative report should document each anastomosis rather than describing only a biliary bypass.
Should modifier 50 be appended?
No. The anatomy and service represented by this code make bilateral reporting with modifier 50 inappropriate.
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 made. 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.
5,71647712,,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
5,72247760,,Fuse bile ducts and bowel,A,,37.36,15.43,NA,15.43,,9.42,62.21,62.21,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068