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    OpenPayerBilling CodesEndoscopy Procedures on the Biliary TractCPT cpt-47554-choledochoscopy-stone-extraction-through-transabdominal-tube
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    CPT 47554: Choledochoscopy with Biliary Stone Extraction

    Medicare pays $401 on average nationally for this procedure.

    CPT code 47554 describes choledochoscopy with removal of one or more biliary duct stones using a biliary endoscope (choledochoscope) passed through an existing abdominal wall tube placed during a prior or associated procedure; this is an endoscopic biliary stone extraction service typically provided in an operating room or procedure suite as a minimally invasive, image-guided therapeutic biliary intervention.

    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.

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    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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    47562Laparoscopy, surgical; cholecystectomyPerformed before or instead of percutaneous approaches when stones are managed surgically; may be part of combined biliary procedures.
    47563Laparoscopy, surgical; cholecystectomy with cholangiographyMay be performed when intraoperative cholangiography or duct exploration is required along with stone removal.
    47564Laparoscopy, surgical; cholecystectomy with exploration of common bile ductRelated operative approach to remove retained common bile duct stones when percutaneous choledochoscopy is not used.
    43260Endoscopic retrograde cholangiopancreatography (ERCP) including sphincterotomyAlternative endoscopic approach for stone removal via the ampulla; may be performed before or after percutaneous techniques in complex cases.
    47120Exploration of common bile duct; with removal of calculusOpen or direct duct exploration code used when stones are removed via open surgical approach rather than percutaneous choledochoscope.
    32551Tube thoracostomy, includes water-seal (eg, chest tube)Unrelated to biliary tree but listed as an example of tube-related procedures; not typically used in biliary workflow (included only when clinically indicated drain procedures are performed).

    Related Modifiers

    8 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…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due 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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2084P0800X
    208D00000X
    1744R1103X
    320800000X
    207QS1201X
    3336I0012X
    246ZA2600X
    122300000X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    E11.9Type 2 diabetes mellitus without complications
    E78.5Hyperlipidemia, unspecified
    I85.01Esophageal varices with bleeding
    K72.90Hepatic failure, unspecified without coma
    K74.60Unspecified cirrhosis of liver
    K74.69Other cirrhosis of liver
    K80.00Calculus of gallbladder with acute cholecystitis without obstruction
    K80.10Calculus of gallbladder with chronic cholecystitis without obstruction
    K80.20Calculus of gallbladder without cholecystitis without obstruction
    K80.30Calculus of bile duct with cholangitis, unspecified, without obstruction

    Showing 1–10 of 25

    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-47553-CHOLEDOCHOSCOPY-BILIARY-VISUALIZATION-BIOPSY

    CPT 47553: Choledochoscopy with Directed Biopsy via Abdominal Tube

    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.
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