No office rate
Both describe biliary-enteric reconstruction. Choose between them using the specific anatomy and procedure documented in the operative report, not merely the shared drainage goal.
On this page
CMS RVU26D · Effective 2026-10-01
47785 Biliary-enteric anastomosis Medicare reimbursement rates in Vermont
Reports surgical reconstruction connecting a bile duct to the bowel to provide bile drainage when the usual route is obstructed or disrupted. Compare 47785 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 47785 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
$2734.11
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.
Digestive surgery
About 47785: Bile duct-to-bowel reconstruction
Reports surgical reconstruction connecting a bile duct to the bowel to provide bile drainage when the usual route is obstructed or disrupted.
The surgeon creates a connection between a bile duct and a segment of bowel so bile can drain into the digestive tract. This reconstruction may be performed during abdominal surgery when the normal biliary pathway cannot provide adequate drainage. The operative report should identify the duct and bowel involved and describe the anastomosis; the code is not for connecting the gallbladder to bowel or simply exploring a duct.
Report 47785 for the biliary-to-bowel reconstruction supported by the operative details, distinguishing it from neighboring codes by the anatomy and technique documented. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 47785
- 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 RVU54.79 · 62%
- Practice expense (office) RVU20.17 · 23%
- Malpractice RVU14.03 · 16%
383
Medicare services in 2024 · #3772 by national volume
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.
47785 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
47765 is identified for reconstruction involving liver ducts and bowel. Use 47785 only when the documented procedure matches its specific bile duct-to-bowel code description.
No office rate
47720 connects the gallbladder to the gastrointestinal tract; 47785 is for a connection involving a bile duct.
Compare 47785 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
$2734.11
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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 47785 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
5,725
- Code
- 47785
- Physician work
- 54.79
- Practice expense
- 20.17
- Malpractice
- 14.03
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 54.79 | × 1.000 | 54.7900 |
| Practice expense | 20.17 | × 0.990 | 19.9683 |
| Malpractice | 14.03 | × 0.506 | 7.0992 |
| Total RVUs | 81.8575 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$2734.11
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 54.79 | 1 |
| Practice expense | 20.17 | 0.99 |
| Malpractice | 14.03 | 0.506 |
(54.79 × 1 + 20.17 × 0.99 + 14.03 × 0.506) × $33.4009 = $2734.11
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.
47785 billing questions
How is 47785 distinguished from other bile duct-to-bowel codes?
Use the operative report to identify the duct, bowel, and reconstruction performed, then match those details to the specific code description. Codes in this group are not interchangeable based only on the fact that bile drains into bowel.
Can gallbladder-to-bowel reconstruction be reported with 47785?
No. 47785 describes a bile duct-to-bowel reconstruction; gallbladder-to-bowel procedures are represented by different codes, such as 47720.
Is modifier 50 appropriate for 47785?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor and anatomy.
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.
How are other same-session procedures paid?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure 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 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.
5,72247760,,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
5,72347765,,Fuse liver ducts & bowel,A,,50.89,19.10,NA,19.10,,13.64,83.63,83.63,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,72447780,,Fuse bile ducts and bowel,A,,41.26,16.56,NA,16.56,,10.55,68.37,68.37,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,72547785,,Fuse bile ducts and bowel,A,,54.79,20.17,NA,20.17,,14.03,88.99,88.99,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,72647800,,Reconstruction of bile ducts,A,,25.52,11.93,NA,11.93,,6.37,43.82,43.82,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,72747801,,Placement bile duct support,A,,17.16,9.72,NA,9.72,,4.19,31.07,31.07,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,72847900,,Suture bile duct injury,A,,21.88,11.13,NA,11.13,,5.85,38.86,38.86,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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