CPT 47612 Cholecystectomy Reimbursement & Benchmarks | OpenPayer

Summary & Overview

CPT 47612: Cholecystectomy with Biliary-Enteric Anastomosis

CPT code 47612 represents a cholecystectomy with exploration of the common bile duct and creation of a biliary-enteric anastomosis when a ductal obstruction cannot be cleared. This procedure is clinically significant because it treats complicated gallbladder disease and prevents ongoing biliary obstruction, with implications for surgical decision-making, resource utilization, and national inpatient and ambulatory surgical workflows. Key national payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the procedure's clinical intent and typical care settings, plus benchmarking context for coverage and utilization across major payer types. The publication summarizes common modifiers observed for surgical and technical components, highlights service line placement for surgical billing, and outlines where related coding or policy questions typically arise. It is intended for billing professionals, surgical teams, and policy analysts who need a clear, national-level reference on coding, site-of-service considerations, and what to expect from major payers regarding authorization and claims processing. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 47612cholecystectomybiliary-enteric anastomosisgeneral surgerysurgical billingoperating roomambulatory surgeryinpatient surgery

Billing Code Overview

CPT code 47612 describes a surgical procedure that removes the gallbladder (cholecystectomy) and creates a new connection between the common bile duct and the small intestine (biliary-enteric anastomosis) when a bile duct obstruction is found that cannot be cleared. The procedure addresses gallbladder disease complicated by an obstructed common bile duct and ensures continued bile flow into the small intestine.

Service type: Combined cholecystectomy with biliary-enteric bypass (open or laparoscopic surgical procedure)
Typical site of service: Inpatient or outpatient operating room within a hospital or ambulatory surgery center, depending on clinical complexity and patient status.

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.

Coding Specifications

Modifier

CPT 47711: Excision of Extrahepatic Bile Duct Mass with Repair

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

CPT 47700: Exploratory Biliary Surgery with Diagnostic Biopsy and Cholangiography

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

CPT 47701: Hepatic Biliary-Enteric Anastomosis for Biliary Atresia

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

CPT 47605: Cholecystectomy with Intraoperative Cholangiography

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

CPT 47610: Cholecystectomy with Common Bile Duct Exploration

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

CPT 47715: Excision of Cystic Lesion in Bile Duct to Restore Bile Flow

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

CPT 47712: Excision of Intrahepatic Biliary Duct Mass with Bile Duct Repair

CPT-47600-LAPAROSCOPIC-CHOLECYSTECTOMY-GALLBLADDER-REMOVAL

CPT 47600: Cholecystectomy (Gallbladder Removal)

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

CPT 47620: Cholecystectomy with Common Bile Duct Exploration and Sphincter Repair

Taxonomy Code	Specialty	Notes
207L00000X	General Surgery	General surgeons commonly perform cholecystectomy with CBD exploration and biliary-enteric anastomosis.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K80.20`	Calculus of gallbladder without cholecystitis without obstruction	Cholelithiasis prompting cholecystectomy; may be associated with CBD stones requiring exploration.

| K80.50 | Calculus of bile duct without cholangitis or cholecystitis | Choledocholithiasis causing obstruction that may necessitate CBD exploration and bypass when clearance fails.

| K83.1 | Obstruction of bile duct | Direct indication for biliary-enteric bypass such as choledochojejunostomy performed in 47612.

| K81.1 | Acute cholecystitis | Indication for cholecystectomy; intraoperative CBD exploration may be performed if obstruction suspected.

| C24.0 | Malignant neoplasm of extrahepatic bile duct | Malignant obstruction of the bile duct that may require biliary bypass as performed in 47612.

| C23 | Malignant neoplasm of gallbladder | Tumor-related biliary obstruction or gallbladder disease leading to combined resection and bypass.

| K83.8 | Other specified diseases of bile duct | Covers inflammatory or stricturing conditions that may necessitate reconstruction or bypass.

| K82.9 | Disease of gallbladder, unspecified | General gallbladder disease prompting cholecystectomy with potential CBD exploration.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`47562`	Laparoscopic cholecystectomy with exploration of common bile duct, includes removal of calculi when performed	Often 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.

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