Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesEndoscopy Procedures on the Biliary TractCPT cpt-47553-choledochoscopy-biliary-visualization-biopsy
    Ask Trek AI about this page

    CPT 47553: Choledochoscopy with Directed Biopsy via Abdominal Tube

    Medicare pays $255 on average nationally for this procedure.

    CPT code 47553 describes choledochoscopy with directed biopsy performed through an existing transabdominal tube to visualize the biliary ducts and obtain tissue for diagnostic evaluation; this represents an endoscopic biliary diagnostic procedure (choledochoscopy with biopsy) typically performed as an operative/interventional service in an inpatient or outpatient surgical setting, using a choledochoscope introduced via a preexisting abdominal access tube.

    For related coverage guidance, see recent payer policy updates: Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders, Esophagogastroduodenoscopy (EGD) Coverage Policy, Radiofrequency Therapy for Fecal Incontinence.

    Customize your policy alerts

    Sign up for cpt 47553 policy alerts

    Get alerted when payer policies referencing 47553 are released or updated.

    Monitor payer policy activity

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

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 64-year-old patient with a history of prior hepatic surgery presents with persistent cholestatic liver tests and intermittent right upper quadrant pain. Imaging (MRCP/ultrasound) demonstrates intrahepatic ductal dilatation and a suspected stricture adjacent to a surgically placed external biliary drainage catheter. The interventional hepatobiliary surgeon plans a choledochoscopy-guided diagnostic evaluation. The provider passes a choledochoscope through the existing percutaneous transhepatic biliary drainage catheter tract to directly visualize the biliary ducts, assess for strictures or tumor, and obtain targeted tissue biopsy samples for histopathology and microbiology. The procedure is performed in a procedural suite or operating room under moderate sedation or general anesthesia depending on comorbidity and airway considerations. Fluoroscopic imaging may be used adjunctively. Post-procedure workflow includes hemostasis assessment, catheter management (replacement, upsizing, or removal as indicated), brief recovery monitoring, specimen handling and labeling, and documentation of findings and pathology requests for correlating biliary pathology with imaging and clinical presentation.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    47531Insertion of percutaneous transhepatic biliary drainage catheter, initial placementOften performed prior to or at the same operative encounter to establish access for subsequent choledochoscopy through the catheter tract
    47532Repositioning or exchange of percutaneous transhepatic biliary drainage catheterMay be performed before choledochoscopy to optimize tract access or replace malfunctioning catheters
    47540Choledochotomy with exploration of common bile duct; with removal of calculusOpen surgical exploration that may be an alternative or complement when endoscopic/choledochoscopic biopsy is non-diagnostic
    43260Endoscopic retrograde cholangiopancreatography (ERCP) diagnostic, with or without collection of specimen(s) by brushing or washingERCP may be performed before or after percutaneous choledochoscopy for ductal visualization, stent placement, or additional sampling
    47554Choledochoscopy, removal of calculus or foreign body from biliary duct, via existing tubeA related choledochoscopy code addressing therapeutic extraction procedures often performed in the same clinical pathway

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    208800000X
    207RH0000X
    207K00000X
    363A00000X
    2080H0002X
    332S00000X
    372600000X

    Related Payer Policy Updates

    Specialty: Gastroenterology1 / 3

    10 rows

    PolicyPayerEffective Date
    Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disordersbcbsvermont2026-12-01
    Esophagogastroduodenoscopy (EGD) Coverage Policyevicore2026-11-05
    Radiofrequency Therapy for Fecal IncontinenceCigna2026-10-15
    Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD)univerahealthcare2026-10-15
    High-Resolution Anoscopy (HRA)Premera Bluecross2026-10-01
    Gastroesophageal and Gastrointestinal (GI) Services and ProceduresColorado Rocky Mountain Health Plans2026-10-01
    Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingOscar Health2026-10-01
    Serum Testing for Hepatic Fibrosis in the Evaluation and Monitoring of Chronic Liver DiseaseOscar Health2026-10-01
    Pancreatic Enzyme Testing for Acute PancreatitisOscar Health2026-10-01
    Helicobacter pylori TestingOscar Health2026-10-01

    Related Codes

    CPT-47550-BILIARY-ENDOSCOPY-CHOLEDOCHOSCOPY-INTRAOPERATIVE

    CPT 47550: Biliary Endoscopy (Choledochoscopy) During Gallbladder Surgery

    CPT-47552-ENDOSCOPIC-DIAGNOSTIC-BILIARY-TRACT-EXAM

    CPT 47552: Diagnostic Endoscopy of the Biliary Tract with Brushing/Washing

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

    CPT 47554: Choledochoscopy with Biliary Stone Extraction

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

    CPT 47555: Choledochoscopic Dilation of Biliary Duct via Existing Abdominal Tube

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

    CPT 47556: Choledochoscopy with Biliary Dilation and Stent Placement

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    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.