Summary & Overview
CPT 47554: Choledochoscopy with Biliary Stone Extraction
CPT code 47554 designates choledochoscopy with extraction of biliary stones performed through an existing transabdominal tube. This endoscopic procedure uses a choledochoscope to visualize the biliary ducts, identify obstructions, and remove one or more calculi. The code is relevant for facilities and clinicians who manage biliary obstruction when percutaneous access is present and is commonly applied in operative or interventional suite settings.
Key payers included in the national analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, typical sites of service, and commonly applied billing modifiers. The publication outlines benchmarks and reimbursement context where available, summarizes relevant policy considerations affecting coverage and prior authorization, and highlights coding considerations for accurate reporting of a choledochoscopy with stone extraction performed via an existing abdominal tube.
This summary is intended for national audiences including hospital coding teams, interventional radiology and surgical departments, and revenue cycle professionals seeking a concise reference for CPT code 47554. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 47554 describes a choledochoscopy with stone extraction performed through an existing transabdominal tube. The provider advances a biliary endoscope (choledochoscope), a tubular instrument with a light source and camera, into the biliary ducts to visualize obstructions and remove one or more stones or calculi.
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Service type: Endoscopic biliary stone removal via choledochoscope through an existing abdominal tube
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Typical site of service: Operative or procedural setting such as an operating room or interventional suite where an existing transabdominal tube provides access to the biliary tree
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of choledocholithiasis presents after a prior open cholecystectomy and placement of a percutaneous transhepatic biliary drainage (PTBD) catheter during hospitalization for obstructive jaundice. Imaging shows retained common bile duct stones causing intermittent biliary obstruction and cholestatic liver enzyme elevation. The patient is scheduled to undergo percutaneous choledochoscopy with stone extraction through the existing abdominal tube tract. The procedure is performed in an interventional radiology or operating room setting under moderate sedation or monitored anesthesia care. The choledochoscope is inserted through the established external biliary drain tract, the biliary tree is directly visualized, stones are grasped and removed or fragmented, and the PTBD catheter may be exchanged or removed at the conclusion of the procedure. Typical peri-procedure workflow includes pre-procedure consent, review of coagulation status and antibiotics, fluoroscopic and endoscopic guidance, specimen handling if needed, and post-anesthesia recovery with observation for bleeding, bile leak, or infection.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Office or other outpatient services (default) | Use when service is performed in the usual, uncomplicated manner without unusual circumstances. |