Billing code 47460: Biliary sphincterotomyMedicare rate & RVUs in Nevada
Reports surgical incision of the biliary sphincter, such as during operative treatment of an obstruction at the distal bile duct outlet.
CMS doesn’t publish an office rate for 47460 in Nevada.
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 47460 covers
This code represents a surgeon’s operative incision of the biliary sphincter, the outlet where bile passes into the intestine. It is distinct from an endoscopic sphincterotomy performed through an ERCP scope. A general or hepatobiliary surgeon may perform the surgical procedure in a hospital operating room when operative access to the sphincter is needed, for example, in treating an obstruction at the distal bile duct outlet.
Report the code when the operative record supports a surgical sphincter incision, rather than only a bile duct incision or an endoscopic procedure. Documentation should identify the operative approach, the sphincter treated, and the reason for the incision. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures 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 for this code. An assistant at surgery may be paid; 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.
47460 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $1,166.65 |
How the 47460 rate is calculated
Each of 47460’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 · 47460
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 20.01Practice expense 10.46Malpractice 5.34
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 47460
47460 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 47460
Biliary sphincterotomy
| 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 · 47460
Biliary sphincterotomy
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
47460 without 51 · national facility
$1,196.09
Biliary sphincterotomy
47460-51 · Second procedure: 50%
$598.05
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%).
47460 compared with similar codes
Compare codes
47460 vs 43262 vs 47420 vs 47425: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 43262ERCP sphincterotomy
- 43262 describes endoscopic sphincterotomy performed during ERCP; 47460 is for surgical incision of the biliary sphincter.
- 47420Bile duct surgery
- 47420 concerns incision of the bile duct, typically for duct exploration; 47460 targets the biliary sphincter.
- 47425Bile duct surgery
- 47425 is associated with bile duct incision and calculus removal. Choose 47460 when the documented surgical work is sphincter incision.
47460 billing questions
How is this different from endoscopic sphincterotomy?
This code is for a surgical approach to the biliary sphincter. For sphincterotomy performed endoscopically during ERCP, consider 43262.
When would a bile duct incision code be more appropriate?
Use a duct-incision code when the documented operation is directed at opening the bile duct for exploration or stone removal, rather than incising the sphincter.
Should modifier 50 be reported?
No. The anatomy and descriptor make bilateral reporting with modifier 50 inappropriate.
What global 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?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and CMS does not permit team-surgery reporting.
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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