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    v1.0.30
    OpenPayerBilling CodesExcision Procedures on the Biliary TractCPT cpt-47612-cholecystectomy-with-biliary-enteric-anastomosis
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    CPT 47612: Cholecystectomy with Common Bile Duct Exploration and Biliary-Enteric Anastomosis

    Medicare pays $1199 on average nationally for this procedure.

    CPT code 47612 describes a surgical procedure in which the provider removes the gallbladder (cholecystectomy), explores the common bile duct, and when an obstruction cannot be cleared, creates a biliary-enteric anastomosis (new connection between the common bile duct and the small intestine) to restore bile flow; service type: open or biliary surgery, typical site of service: operating room in an inpatient or outpatient surgical facility or hospital setting.

    For related coverage guidance, see recent payer policy updates: Surgical Procedures, Outpatient Surgical Procedures - Site of Service, Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults.

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    Table of contents

    Progress1 / 7

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    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old female with a history of symptomatic cholelithiasis and recurrent biliary colic presents with new onset jaundice, right upper quadrant pain, and elevated bilirubin. Preoperative ultrasound and MRCP demonstrate gallstones and a common bile duct (CBD) obstruction that could not be cleared endoscopically or percutaneously. The surgical team schedules a cholecystectomy with intraoperative exploration of the CBD. During surgery, the surgeon performs an open or laparoscopic 47612 procedure: removal of the gallbladder with exploration of the common bile duct, and creation of a choledochojejunostomy (a biliary-enteric bypass) when the obstruction cannot be relieved by stone extraction.

    Clinical workflow:

    • Preoperative evaluation: history, physical, liver function tests, imaging (ultrasound, MRCP/CT), and anesthesia assessment.

    • Intraoperative steps: induction of anesthesia; laparoscopic or open cholecystectomy; intraoperative cholangiography or choledochoscopy to evaluate the duct; attempted stone extraction or CBD exploration; when obstruction persists and cannot be cleared, construction of a biliary-enteric anastomosis (choledochojejunostomy) to restore bile flow.

    • Immediate postoperative care: monitoring in PACU, pain control, assessment of bile leak or infection, serial labs for liver function.

    • Follow-up: wound check, liver enzyme trend, nutritional counseling; potential ERCP or imaging if postoperative obstruction or complications arise.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    47562Laparoscopic cholecystectomy with exploration of common bile duct, includes removal of calculi when performedOften performed when CBD stones are suspected; may be attempted prior to conversion to 47612 if obstruction cannot be cleared.

    | 47563 | Laparoscopic cholecystectomy with exploration of common bile duct and removal of stone(s) by choledochotomy | Used when stones are removed laparoscopically through a choledochotomy during cholecystectomy; if stones cannot be cleared or reconstruction required, 47612 may be performed.

    | 43840 | Jejunostomy, bypass, or anastomosis procedures (examples of small intestine anastomosis) | Codes for small bowel anastomosis techniques that conceptually relate to creation of a biliary-enteric anastomosis during 47612.

    | 47570 | Laparoscopy, surgical; cholecystectomy — when converted to open | Represents conversion scenarios when laparoscopic approach is aborted and open 47612 may be completed.

    | 43275 | Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and/or stone removal | Often attempted preoperatively to clear CBD obstruction; failure of ERCP can lead to proceeding with 47612.

    Related Modifiers

    9 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…
    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…
    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…
    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…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    2080P0206X
    208800000X
    174200000X
    2080P0207X
    261QE0700X
    332G00000X
    2470A2800X

    Related ICD-10-CM Codes

    28 rows

    ICD-10-CM CodeDescription
    E86.0Dehydration
    E86.1Hypovolemia
    I10Essential (primary) hypertension
    I85.00Esophageal varices without bleeding
    K55.9Vascular disorder of intestine, unspecified
    K75.9Inflammatory liver disease, unspecified
    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 28

    Related Payer Policy Updates

    Specialty: General Surgery1 / 2

    10 rows

    PolicyPayerEffective Date
    Surgical ProceduresUnitedHealthcare2026-09-01
    Outpatient Surgical Procedures - Site of ServiceUnitedHealthcare2026-09-01
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01
    Medical Necessity Guidelines — Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Ambulatory Surgery Center (ASC) - Site of Care PolicyKaiser Permanente2026-08-01

    Related Codes

    CPT-47600-LAPAROSCOPIC-CHOLECYSTECTOMY-GALLBLADDER-REMOVAL

    CPT 47600: Open Cholecystectomy, Removal of Gallbladder

    CPT-47605-LAPAROSCOPIC-CHOLECYSTECTOMY-WITH-INTRAOPERATIVE-CHOLANGIOGRAM

    CPT 47605: Laparoscopic Cholecystectomy with Intraoperative Cholangiography

    CPT-47610-CHOLECYSTECTOMY-COMMON-BILE-DUCT-EXPLORATION

    CPT 47610: Cholecystectomy with Common Bile Duct Exploration

    CPT-47620-CHOLECYSTECTOMY-COMMON-BILE-DUCT-EXPLORATION-SPHINCTER-REPAIR

    CPT 47620: Cholecystectomy with Common Duct Exploration and Sphincter Repair

    CPT-47700-BILIARY-EXPLORATION-WITH-DIAGNOSTIC-BIOPSY-CHOLANGIOGRAPHY

    CPT 47700: Exploration of Biliary System with Diagnostic Biopsy

    CPT-47701-HEPATIC-BILIARY-ENTERIC-ANASTOMOSIS-FOR-BILIARY-ATRESIA

    CPT 47701: Portoenterostomy (Kasai) for Biliary Atresia

    CPT-47711-EXTRAHEPATIC-BILE-DUCT-MASS-EXCISION-BILE-DUCT-REPAIR

    CPT 47711: Excision of Extrahepatic Biliary Duct Mass

    CPT-47712-INTRAHEPATIC-BILIARY-DUCT-MASS-EXCISION-BILE-DUCT-REPAIR

    CPT 47712: Excision of Intrahepatic Biliary Duct Mass

    CPT-47715-BILE-DUCT-CYST-EXCISION-RESTORATION-OF-BILE-FLOW

    CPT 47715: Excision of Cystic Lesion of Bile Duct

    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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