Billing code 47147: Liver graft preparationMedicare rate & RVUs in Washington
Reports backbench preparation of a whole cadaveric donor liver graft when the transplant surgeon performs arterial reconstruction before transplantation.
CMS doesn’t publish an office rate for 47147 in Washington.
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 47147 covers
A transplant surgeon performs this backbench service on a cadaveric whole-liver graft before it is implanted in the recipient. The work includes preparing the graft and reconstructing its arterial supply to make it suitable for transplantation. It is generally performed in the operating room during a liver transplant episode, separate from the recipient operation itself.
Choose this code when the documented graft preparation includes arterial reconstruction; preparation without that work or preparation involving venous reconstruction belongs to a different code in the series. The operative report should identify the donor graft, the backbench preparation performed, and the arterial reconstruction. Medicare applies the standard multiple procedure reduction when other procedures subject to that rule are performed in the same session: the highest-valued procedure is paid in full, and the others are paid at 50%.
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 47147 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $335.33 |
| Seattle (King Cnty) | Unavailable | $356.82 |
How the 47147 rate is calculated
Each of 47147’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 · 47147
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.83Practice expense 1.67Malpractice 1.79
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 47147
The CMS indicators that decide how 47147 is paid alongside other services.
CMS payment indicators · 47147
Liver graft preparation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
47147 without 51 · national facility
$343.70
Liver graft preparation
47147-51 · Second procedure: 50%
$171.85
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%).
47147 compared with similar codes
Compare codes
47147 vs 47143 vs 47146 vs 47144: national Medicare rates
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How to choose
- 47143Prep donor liver whole
- 47143 covers standard backbench preparation of a whole donor liver graft without reconstruction. Choose 47147 when arterial reconstruction is performed.
- 47146Graft preparation
- Both describe backbench graft preparation, but 47146 identifies venous reconstruction and 47147 identifies arterial reconstruction.
- 47144Prep donor liver 3-segment
- 47144 concerns preparation of a three-segment donor liver graft. 47147 is distinguished by arterial reconstruction of a whole donor liver graft.
47147 billing questions
When should 47147 be chosen over 47143?
Use 47147 when backbench preparation of a whole cadaveric donor liver includes arterial reconstruction. Code 47143 describes standard whole-graft preparation without that reconstruction.
How does 47147 differ from 47146?
The distinguishing work is arterial reconstruction for 47147 and venous reconstruction for 47146. Follow the operative report’s description of the graft reconstruction.
Can 47147 be reported with the recipient liver transplant?
The backbench graft preparation and the recipient transplant are distinct services and may be reported in the same transplant episode when both are performed and documented.
What documentation supports 47147?
Document that the graft was prepared on the backbench before implantation and describe the arterial reconstruction performed. A record of graft preparation alone does not establish the arterial work that distinguishes this code.
How does Medicare handle multiple procedures in the same session?
Under the standard multiple procedure reduction, Medicare pays the highest-valued procedure in full and pays the others at 50% when the procedures are performed in the same session.
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
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