Find policies, billing codes, payers, states, and providers

CPT 47550: Intraoperative Biliary Endoscopy (Choledochoscopy)

CPT code 47550 denotes intraoperative insertion of a biliary endoscope (choledochoscope) into the biliary ducts during gallbladder surgery to detect obstructions or other abnormalities. Nationally, this code captures a targeted diagnostic step during cholecystectomy and related biliary procedures that can influence immediate surgical decision-making, guide stone extraction, and affect downstream care.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when this diagnostic endoscopy is performed, typical sites of service, and common operative scenarios in which the code is used.

The publication summarizes benchmarks and utilization patterns where available, highlights payer coverage considerations and coding practice implications, and outlines clinical context relevant to surgeons and coding professionals. Data not available in the input will be noted as such. The goal is to provide a concise reference for clinicians, coding staff, and policy analysts seeking a national-level understanding of CPT code 47550 and its role in biliary surgery workflows.

Customize your policy alerts

Sign up for cpt 47550 policy alerts

Get alerted when payer policies referencing 47550 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CPT code 47550 describes insertion of a biliary endoscope (choledochoscope) into the ducts of the biliary system during gallbladder surgery to identify abnormalities or blockages. This procedure is performed intraoperatively as part of a surgical exploration of the biliary tract.

Service type: Intraoperative diagnostic endoscopy of the biliary ducts performed during cholecystectomy or related biliary surgery
Typical site of service: Hospital operating room or ambulatory surgery center during gallbladder or biliary tract surgery

Find policies, billing codes, payers, states, and providers

CPT 47550: Intraoperative Biliary Endoscopy (Choledochoscopy)

Customize your policy alerts

Sign up for cpt 47550 policy alerts

Get alerted when payer policies referencing 47550 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service type: Intraoperative diagnostic endoscopy of the biliary ducts performed during cholecystectomy or related biliary surgery
Typical site of service: Hospital operating room or ambulatory surgery center during gallbladder or biliary tract surgery

Clinical & Coding Specifications

Clinical Context

A 52-year-old female presents with symptomatic cholelithiasis and episodic right upper quadrant pain with suspected choledocholithiasis based on abnormal liver function tests and a dilated common bile duct on abdominal ultrasound. The patient is scheduled for an open or laparoscopic cholecystectomy. During the operation, the surgeon inserts a biliary endoscope (choledochoscope) into the cystic duct or common bile duct to visualize the biliary tree, identify retained stones, inspect for strictures or mucosal abnormalities, and assist with stone extraction or ductal clearance. Intraoperative workflow includes preoperative consent for possible common bile duct exploration, anesthesia induction, surgical exposure of the gallbladder and cystic duct, intraoperative choledochoscopy (47550) for direct visualization, potential retrieval of stones with baskets or irrigation, and placement of a T-tube or primary duct closure if indicated. Postoperative care involves monitoring liver enzymes, bilious drainage if a tube was placed, and follow-up imaging or labs as needed.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when intraoperative choledochoscopy required substantially greater work due to extensive adhesiolysis or complex stone extraction beyond typical effort.
`52`	Reduced services	Use if the choledochoscopy was started but substantially reduced or not completed for documented clinical reasons.
`53`	Discontinued procedure	Use if the choledochoscopy was aborted before completion due to patient instability or anatomic impossibility.
`59`	Distinct procedural service	Use to indicate a distinct procedure separate from the primary cholecystectomy if billing requires differentiation from other intra-abdominal procedures.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons during complex biliary exploration and both perform substantial portions of the procedure.
`66`	Surgical team	Use when a primary surgeon and surgical team members perform portions of the biliary endoscopy as part of a covered surgical team arrangement.
`78`	Unplanned return to OR for related procedure during postoperative period	Use if the patient returns to the operating room for a complication related to the initial choledochoscopy (for example, retained stone requiring re-exploration).
`50`	Bilateral procedure	Generally not applicable to biliary endoscopy but included when reporting laterality-based payer rules require explicit modifier presence.
`26`	Professional component	Use when reporting only the surgeon’s professional component separate from technical facility charges (rare for intraoperative procedures billed by hospitals).
`TC`	Technical component	Use when reporting only the facility/technical component of the procedure separate from the surgeon’s professional component.
`59`	Distinct procedural service	Use when choledochoscopy is unrelated to other billed services during the same operative session and needs separation (duplicate entry consolidated above as standard CMS modifier).

Taxonomy Code	Specialty	Notes
207K00000X	General Surgery	Most common specialty performing `47550` during cholecystectomy and common bile duct exploration.
207XS0100X	Gastroenterology	May perform operative choledochoscopy in select cases or assist intraoperatively for endoscopic expertise.
207L00000X	Surgical Oncology	Performs biliary exploration in complex malignant biliary disease cases.
207V00000X	Colon & Rectal Surgery	Occasionally involved when colorectal pathology and hepatobiliary surgery coincide.
335E00000X	Acute Care Surgery	Performs urgent or emergent biliary explorations in acute presentations.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K80.10`	Calculus of bile duct without cholangitis or cholecystitis	Choledochoscopy used to locate and remove common bile duct stones during surgery.
`K80.50`	Calculus of gallbladder with other cholecystitis without obstruction	Gallbladder stones with inflammation may prompt cholecystectomy and intraoperative bile duct evaluation.
`K83.1`	Obstruction of bile duct	Direct visualization via choledochoscope assists in identifying level and cause of obstruction.
`K83.0`	Cholangitis	When suspected, choledochoscopy can assess duct integrity and stones; therapeutic adjuncts may be required.
`K83.8`	Other specified diseases of biliary tract	Used for biliary strictures, mucosal lesions, or other abnormalities seen on choledochoscopy.
`K80.00`	Calculus of gallbladder without cholecystitis	Routine cholecystectomy cases may include choledochoscopy if ductal stones are suspected.
`K82.1`	Cholecystitis, chronic	Chronic inflammation can be associated with ductal pathology prompting intraoperative inspection.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`47562`	Laparoscopy, surgical; cholecystectomy	Frequently performed before or along with `47550` when choledochoscopy is performed during laparoscopic cholecystectomy.
`47563`	Laparoscopy, surgical; cholecystectomy with cholangiography	Intraoperative cholangiogram often pairs with choledochoscopy to evaluate biliary anatomy and ductal stones.
`43264`	Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy	ERCP may be performed preoperatively or postoperatively for ductal stone extraction as an adjunct or alternative to intraoperative choledochoscopy.
`47540`	Exploration of common bile duct; with removal of calculus	Often performed in conjunction with choledochoscopy for direct stone extraction and duct clearance.
`49440`	Insertion of percutaneous transhepatic biliary drainage catheter	May be used postoperatively for biliary decompression if choledochoscopy reveals obstructing pathology not amenable to immediate repair.

CPT 47552: Endoscopic Diagnostic Examination of Biliary Tract

CPT-47553-CHOLEDOCHOSCOPY-BILIARY-VISUALIZATION-BIOPSY

CPT 47553: Choledochoscopy for Biliary Visualization and Biopsy

CPT-47554-CHOLEDOCHOSCOPY-STONE-EXTRACTION-THROUGH-TRANSABDOMINAL-TUBE

CPT 47554: Choledochoscopy with Biliary Stone Extraction

CPT-47555-CHOLEDOCHOSCOPY-DILATION-THROUGH-TRANSABDOMINAL-ACCESS

CPT 47555: Choledochoscopy with Biliary Dilation via Transabdominal Access

CPT-47556-CHOLEDOCHOSCOPY-DILATION-STENT-VIA-TRANSABDOMINAL-TUBE

CPT 47556: Choledochoscopy with Biliary Dilation and Stent Placement

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when intraoperative choledochoscopy required substantially greater work due to extensive adhesiolysis or complex stone extraction beyond typical effort.
`52`	Reduced services	Use if the choledochoscopy was started but substantially reduced or not completed for documented clinical reasons.
`53`	Discontinued procedure	Use if the choledochoscopy was aborted before completion due to patient instability or anatomic impossibility.
`59`	Distinct procedural service	Use to indicate a distinct procedure separate from the primary cholecystectomy if billing requires differentiation from other intra-abdominal procedures.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons during complex biliary exploration and both perform substantial portions of the procedure.
`66`	Surgical team	Use when a primary surgeon and surgical team members perform portions of the biliary endoscopy as part of a covered surgical team arrangement.
`78`	Unplanned return to OR for related procedure during postoperative period	Use if the patient returns to the operating room for a complication related to the initial choledochoscopy (for example, retained stone requiring re-exploration).
`50`	Bilateral procedure	Generally not applicable to biliary endoscopy but included when reporting laterality-based payer rules require explicit modifier presence.
`26`	Professional component	Use when reporting only the surgeon’s professional component separate from technical facility charges (rare for intraoperative procedures billed by hospitals).
`TC`	Technical component	Use when reporting only the facility/technical component of the procedure separate from the surgeon’s professional component.
`59`	Distinct procedural service	Use when choledochoscopy is unrelated to other billed services during the same operative session and needs separation (duplicate entry consolidated above as standard CMS modifier).

Taxonomy Code	Specialty	Notes
207K00000X	General Surgery	Most common specialty performing `47550` during cholecystectomy and common bile duct exploration.
207XS0100X	Gastroenterology	May perform operative choledochoscopy in select cases or assist intraoperatively for endoscopic expertise.
207L00000X	Surgical Oncology	Performs biliary exploration in complex malignant biliary disease cases.
207V00000X	Colon & Rectal Surgery	Occasionally involved when colorectal pathology and hepatobiliary surgery coincide.
335E00000X	Acute Care Surgery	Performs urgent or emergent biliary explorations in acute presentations.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K80.10`	Calculus of bile duct without cholangitis or cholecystitis	Choledochoscopy used to locate and remove common bile duct stones during surgery.
`K80.50`	Calculus of gallbladder with other cholecystitis without obstruction	Gallbladder stones with inflammation may prompt cholecystectomy and intraoperative bile duct evaluation.
`K83.1`	Obstruction of bile duct	Direct visualization via choledochoscope assists in identifying level and cause of obstruction.
`K83.0`	Cholangitis	When suspected, choledochoscopy can assess duct integrity and stones; therapeutic adjuncts may be required.
`K83.8`	Other specified diseases of biliary tract	Used for biliary strictures, mucosal lesions, or other abnormalities seen on choledochoscopy.
`K80.00`	Calculus of gallbladder without cholecystitis	Routine cholecystectomy cases may include choledochoscopy if ductal stones are suspected.
`K82.1`	Cholecystitis, chronic	Chronic inflammation can be associated with ductal pathology prompting intraoperative inspection.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`47562`	Laparoscopy, surgical; cholecystectomy	Frequently performed before or along with `47550` when choledochoscopy is performed during laparoscopic cholecystectomy.
`47563`	Laparoscopy, surgical; cholecystectomy with cholangiography	Intraoperative cholangiogram often pairs with choledochoscopy to evaluate biliary anatomy and ductal stones.
`43264`	Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy	ERCP may be performed preoperatively or postoperatively for ductal stone extraction as an adjunct or alternative to intraoperative choledochoscopy.
`47540`	Exploration of common bile duct; with removal of calculus	Often performed in conjunction with choledochoscopy for direct stone extraction and duct clearance.
`49440`	Insertion of percutaneous transhepatic biliary drainage catheter	May be used postoperatively for biliary decompression if choledochoscopy reveals obstructing pathology not amenable to immediate repair.

CPT 47552: Endoscopic Diagnostic Examination of Biliary Tract

CPT-47553-CHOLEDOCHOSCOPY-BILIARY-VISUALIZATION-BIOPSY

CPT 47553: Choledochoscopy for Biliary Visualization and Biopsy

CPT-47554-CHOLEDOCHOSCOPY-STONE-EXTRACTION-THROUGH-TRANSABDOMINAL-TUBE

CPT 47554: Choledochoscopy with Biliary Stone Extraction

CPT-47555-CHOLEDOCHOSCOPY-DILATION-THROUGH-TRANSABDOMINAL-ACCESS

CPT 47555: Choledochoscopy with Biliary Dilation via Transabdominal Access

CPT-47556-CHOLEDOCHOSCOPY-DILATION-STENT-VIA-TRANSABDOMINAL-TUBE

CPT 47556: Choledochoscopy with Biliary Dilation and Stent Placement

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 47550: Intraoperative Biliary Endoscopy (Choledochoscopy)

Sign up for cpt 47550 policy alerts

Billing Code Overview

Catch payer policy changes before they impact reimbursement

Catch payer policy changes before they impact reimbursement

OpenPayer

CPT 47550: Intraoperative Biliary Endoscopy (Choledochoscopy)

Sign up for cpt 47550 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 47550: Intraoperative Biliary Endoscopy (Choledochoscopy)

Sign up for cpt 47550 policy alerts

Billing Code Overview

CPT 47550: Intraoperative Biliary Endoscopy (Choledochoscopy)

Sign up for cpt 47550 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical service does CPT 47550 represent and when is it performed?

Which provider specialties commonly perform intraoperative choledochoscopy billed with 47550?

What other CPT codes commonly relate to or accompany 47550 in operative workflows?

Which modifiers may be relevant when billing CPT 47550 and in what situations are they used?

What diagnosis codes are associated with clinical scenarios for using 47550?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical service does CPT 47550 represent and when is it performed?

Which provider specialties commonly perform intraoperative choledochoscopy billed with 47550?

What other CPT codes commonly relate to or accompany 47550 in operative workflows?

Which modifiers may be relevant when billing CPT 47550 and in what situations are they used?

What diagnosis codes are associated with clinical scenarios for using 47550?

References