Billing code 47400: Liver duct incisionMedicare rate & RVUs in Oregon
Reports an operative incision into an intrahepatic bile duct to explore, drain, or remove a calculus during hepatobiliary surgery.
CMS doesn’t publish an office rate for 47400 in Oregon.
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 47400 covers
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.
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 47400 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,985.81 |
| Rest Of Oregon | Unavailable | $1,897.25 |
How the 47400 rate is calculated
Each of 47400’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 · 47400
RVUs × geographic indexes × conversion factor
Work35.45
35.45 RVUs× 1.000 GPCI
Practice expense14.74
14.74 RVUs× 1.000 GPCI
Malpractice9.49
9.49 RVUs× 1.000 GPCI
Adjusted RVUs
59.6800
Conversion factor
$33.4009
Medicare rate
$1,993.37
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 47400
47400 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 47400
Liver duct incision
| 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 · 47400
Liver duct incision
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
47400 without 51 · national facility
$1,993.37
Liver duct incision
47400-51 · Second procedure: 50%
$996.69
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%).
47400 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 47420Bile duct surgery
- Choose 47400 for an incision into a duct within the liver. Code 47420 concerns an extrahepatic bile duct.
- 47425Bile duct surgery
- Code 47425 addresses an extrahepatic bile duct procedure; 47400 is selected when the operative incision is intrahepatic.
- 47460Biliary sphincterotomy
- Code 47460 is directed at the biliary sphincter. Use 47400 when the surgeon incises an intrahepatic duct instead.
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 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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