Billing code 47420: Bile duct surgeryMedicare rate & RVUs in Washington
Reports operative incision of the bile duct for direct exploration, commonly when a surgeon evaluates suspected obstruction during abdominal surgery.
CMS doesn’t publish an office rate for 47420 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 47420 covers
This service involves surgically opening the bile duct so the surgeon can inspect or explore its lumen, often to investigate suspected stones or another obstruction. It is typically performed by a general or hepatobiliary surgeon in a hospital operating room as part of an abdominal operation. It is distinct from opening the gallbladder and from endoscopic treatment through the papilla.
Report the code when the operative note supports an actual bile-duct incision and exploration. Documentation should identify the duct involved, the reason for exploration, and the operative work performed; a note describing only gallbladder surgery or endoscopic duct treatment does not support this service. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this single-duct procedure.
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 47420 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,223.33 |
| Seattle (King Cnty) | Unavailable | $1,319.39 |
How the 47420 rate is calculated
Each of 47420’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 · 47420
RVUs × geographic indexes × conversion factor
Work21.48
21.48 RVUs× 1.000 GPCI
Practice expense10.23
10.23 RVUs× 1.000 GPCI
Malpractice5.38
5.38 RVUs× 1.000 GPCI
Adjusted RVUs
37.0900
Conversion factor
$33.4009
Medicare rate
$1,238.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 47420
47420 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 47420
Bile duct surgery
| 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 · 47420
Bile duct surgery
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
47420 without 51 · national facility
$1,238.84
Bile duct surgery
47420-51 · Second procedure: 50%
$619.42
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%).
47420 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 47425Bile duct surgery
- Choose 47420 for bile-duct incision with exploration. Choose 47425 when the operative service includes removal of a calculus.
- 47400Liver duct incision
- 47400 concerns hepatic ducts within the liver; 47420 concerns the bile duct outside the liver.
- 47460Biliary sphincterotomy
- 47460 addresses incision or treatment of the biliary sphincter. This code is for an operative incision into the bile duct for exploration.
47420 billing questions
How is this distinguished from 47425?
This code describes bile-duct incision with exploration. Code 47425 is the related variant used when the documented operative service includes removal of a calculus.
Can this be reported for an endoscopic duct procedure?
No. This code represents operative incision and exploration of the bile duct, not endoscopic treatment such as an incision at the biliary sphincter.
What documentation supports reporting it?
The operative report should identify the bile duct opened, the reason for exploration, and the exploration performed. A general reference to biliary evaluation without an incision and exploration is not enough.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How are multiple procedures and surgical assistance handled?
In the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. An assistant may be paid; co-surgeon payment needs supporting documentation, while team surgery 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 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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