Summary & Overview
CPT 47000: Percutaneous Liver Biopsy
CPT code 47000 denotes a percutaneous liver biopsy: removal of a small liver tissue sample through a small skin incision for diagnostic or monitoring purposes. This procedure is central to hepatology practice and matters nationally because it informs diagnosis, staging, and treatment decisions for a wide range of liver conditions, including jaundice, hepatitis, and fibrosis. Payers commonly involved in national coverage and reimbursement conversations include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of the clinical intent and typical sites of service for this procedure, plus what to expect in payer coverage discussions. The publication presents benchmarks and policy-relevant context about billing, utilization, and coding considerations for CPT code 47000, and summarizes common procedural indications and clinical rationale. Where available, it highlights payer approaches to authorization, bundling, and facility versus professional service distinctions. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 47000 describes a percutaneous liver biopsy in which the provider removes a small sample of liver tissue through a small incision in the skin. The procedure is performed to diagnose liver disease, assess severity of known liver disease, or monitor response to treatment, and may be used to evaluate conditions such as jaundice.
Service type: Diagnostic tissue sampling / liver biopsy procedure
Typical site of service: Outpatient procedure suite, ambulatory surgical center, or hospital setting (procedure performed through a small skin incision over the liver)
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient with persistent jaundice, elevated liver enzymes, and imaging showing heterogeneous hepatic parenchyma presents to the hepatology clinic. After noninvasive testing (laboratory studies, abdominal ultrasound, and transient elastography) is inconclusive for etiology and staging, the hepatologist schedules a percutaneous liver biopsy to obtain tissue for histopathology, iron and copper quantification, and staging of fibrosis. The procedure is performed in an outpatient procedural suite or hospital interventional radiology unit. The patient is screened for coagulopathy, holds anticoagulants per institutional policy, and consents for moderate sedation and local anesthesia. Under ultrasound guidance, the clinician creates a small skin incision and advances a biopsy needle into the liver to obtain core tissue samples. Specimens are placed in formalin and sent to pathology; post-procedure observation is performed to monitor for bleeding or pain. Documentation includes indication, imaging guidance, quantity and size of cores, specimen disposition, sedation/analgesia used, informed consent, and post-procedure instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the biopsy required substantially greater work, time, or complexity than typical (document specifics). |