No office rate
Choose 47425 when a calculus is extracted through the bile-duct incision. Choose 47420 for duct exploration without calculus removal as the defining work.
On this page
CMS RVU26D · Effective 2026-10-01
47425 Bile duct surgery Medicare reimbursement rates in Vermont
Reports open incision of the common bile duct to extract a calculus when operative treatment requires direct access to the duct. Compare 47425 office and facility rates across CMS payment localities in Vermont.
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 47425 in Vermont?
Vermont 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
$1184.93
1 of 1 localities have a supported rate.
Payment area: Vermont
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 47425: Open common bile duct stone removal
Reports open incision of the common bile duct to extract a calculus when operative treatment requires direct access to the duct.
Code 47425 represents open choledochotomy to remove a calculus from the common bile duct. The surgeon exposes the extrahepatic duct, incises its wall, and extracts the stone. The procedure is performed by a surgeon in an operating room when open duct surgery is needed for stone removal. It is distinct from an incision of the gallbladder or duct exploration without calculus removal.
Report the code when the operative note supports an incision into the bile duct and extraction of a calculus; documentation should identify the duct and describe the removal. Do not separately report overlapping duct work when a combined cholecystectomy and common-duct procedure describes the operation performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In same-session multiple procedures, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this single-duct service. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 47425
- 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 RVU21.75 · 57%
- Practice expense (office) RVU10.89 · 28%
- Malpractice RVU5.82 · 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.
47425 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Code 47610 describes an open cholecystectomy combined with common-duct exploration. Code 47425 describes open duct incision with calculus removal, not the combined gallbladder operation.
No office rate
Code 47564 is for laparoscopic cholecystectomy with common-duct exploration. Code 47425 represents open choledochotomy with calculus extraction.
No office rate
Code 43264 is used for endoscopic biliary calculus removal during ERCP; 47425 is for open surgical removal through a bile-duct incision.
Compare 47425 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
Vermont →
Office / nonfacility
Unavailable
Facility
$1184.93
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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 47425 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
5,679
- Code
- 47425
- Physician work
- 21.75
- Practice expense
- 10.89
- Malpractice
- 5.82
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.75 | × 1.000 | 21.7500 |
| Practice expense | 10.89 | × 0.990 | 10.7811 |
| Malpractice | 5.82 | × 0.506 | 2.9449 |
| Total RVUs | 35.4760 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$1184.93
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.75 | 1 |
| Practice expense | 10.89 | 0.99 |
| Malpractice | 5.82 | 0.506 |
(21.75 × 1 + 10.89 × 0.99 + 5.82 × 0.506) × $33.4009 = $1184.93
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.
47425 billing questions
How does 47425 differ from 47420?
Use 47425 when the surgeon incises the common bile duct and removes a calculus. Code 47420 describes duct exploration without calculus removal as the defining service.
Can 47425 be reported with a cholecystectomy?
A cholecystectomy may occur during the same operation, but do not separately report duct work that is included in a combined cholecystectomy and common-duct procedure code.
Is modifier 50 appropriate?
No. This is a single bile-duct service, not a bilateral procedure; modifier 50 is inappropriate.
What documentation supports 47425?
The operative report should establish that the surgeon made an incision in the bile duct and removed a calculus. Duct exploration alone does not support this code.
How are assistants and co-surgeons handled?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and team-surgery payment 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.
5,67647399,,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
5,68147480,,Incision of gallbladder,A,,12.92,8.98,NA,8.98,,3.18,25.08,25.08,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,68247490,,Incision of gallbladder,A,,4.64,3.80,NA,3.80,,0.49,8.93,8.93,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817