Summary & Overview

CPT 47145: Backbench Preparation of Cadaver Donor Liver

CPT code 47145 represents the backbench standard preparation of a cadaver donor liver prior to transplantation, a specialized surgical service that readies vascular and biliary structures and can produce two allografts by dividing left and right lobes. This code matters nationally because it underpins payments for critical organ-preparation work that enables liver transplantation and affects hospital transplant program operations and resource allocation. Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise explanation of the service represented by 47145, its clinical context within liver transplant workflows, and the typical site of service. The publication provides benchmarks and comparisons of coverage and payment approaches across major payers, highlights common billing and coding considerations tied to transplant programs, and summarizes relevant policy updates affecting transplantation services. The content also outlines expected service lines and where this procedure appears on the hospital claim. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 47145liver transplantationorgan procurementbackbench preparationtransplant surgeryhospital surgerytransplant billingsurgical procedure coding

Billing Code Overview

CPT code 47145 describes a backbench standard preparation of a cadaver donor liver for transplantation. The procedure includes removal of the gallbladder when needed, excision of surrounding soft tissues, and preparation of vascular and biliary structures — specifically the vena cava, portal vein, hepatic artery, and common bile duct — to ready the organ for transplant. The provider separates segments II, III, and IV of the left lobe from segments I and V to VIII of the right lobe to prepare two allografts.

Service type: Organ procurement and backbench liver preparation

Typical site of service: Hospital operating room or transplant center

Clinical & Coding Specifications

Clinical Context

A deceased donor liver is received in the transplant center operating room sterile backbench area. The organ procurement surgeon or transplant surgeon performs a backbench standard preparation of the cadaveric liver prior to implantation into one or more recipients. The procedure typically occurs after donor organ transport and crossmatch confirmation and before donor organ implantation in the recipient. The surgical team inspects the graft, removes the gallbladder if present, and dissects surrounding soft tissue to mobilize and prepare vascular and biliary structures (vena cava, portal vein, hepatic artery, common bile duct). For split-liver preparations the surgeon separates segments II, III, and IV from segments I and V–VIII to create two allografts. Typical workflow steps include receipt and inspection of the graft, clearing of perihepatic fat and connective tissue, cholangiogram or bile duct assessment as needed, preparation of vascular cuffs and bile duct for anastomosis, and packaging of the graft for implantation. Typical site of service is an operating room within a transplant center, often in a tertiary care hospital. A realistic patient scenario: a multiorgan procurement team recovers a cadaveric liver from a brain-dead donor; the transplant center team performs 47145 backbench preparation to split the liver into two grafts for transplantation into two recipients, with preparation of hepatic veins, portal vein, hepatic artery, and bile duct for subsequent anastomoses.

Coding Specifications

Modifier	Description	When to Use
`00`

Taxonomy Code	Specialty	Notes
208000000X	Transplant Surgery	Primary specialty performing donor liver backbench preparation.
207L00000X	General Surgery	General surgeons with transplant experience may perform or assist with preparation.
207K00000X	Surgical Critical Care	Surgeons involved in perioperative management and team-based transplant care.
2082S0127X	Hepatology (Transplant)	Hepatologists coordinate recipient care and may be involved in planning but do not perform the backbench dissection.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`47145`	Backbench standard preparation of liver from cadaver donor, includes removal of gallbladder and preparation of vena cava, portal vein, hepatic artery, and common bile duct; separation of segments II, III, IV from segments I and V–VIII to prepare two allografts	Primary procedure describing the donor liver backbench preparation and split into two grafts prior to transplantation.
`47146`	Backbench preparation of liver with partial procedures or complex vascular reconstruction (hypothetical adjacent code for context)	Used when additional complex vascular reconstruction beyond standard preparation is performed (if applicable in certain coding systems).
`47135`	Donor hepatectomy (removal of liver from donor) — code for procurement procedure (representative)	Performed prior to `47145` during the organ procurement; provides the liver that is subsequently prepared on the backbench.
`32830`	Ex vivo liver perfusion (example related intraoperative organ preservation code)	May be performed in coordination with backbench preparation for graft preservation during transport/implantation.
`47562`	Liver transplant, recipient total hepatectomy and transplantation (example recipient procedure)	Performed after `47145` on the recipient side when the prepared graft is implanted into the recipient.

Note: If additional billing codes are required for procurement, preservation, anesthesia, or recipient transplantation, they are reported separately and may be billed by different providers or facilities.

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