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CPT 47760: Biliary-Enteric Bypass for Biliary Obstruction

CPT code 47760 denotes a surgical biliary-enteric bypass that connects the extrahepatic bile ducts to the small intestine to reestablish bile flow when biliary obstruction is present, frequently from malignancy. This operation is clinically significant because it addresses obstructive jaundice, reduces cholestasis-related complications, and can be palliative or part of curative surgical strategies. Nationally, this code is relevant to hospital surgical services, surgical oncology, and hepatobiliary specialty care.

Key payers addressed in this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the procedure, typical sites of service, and the common billing modifiers associated with major surgical services. The report presents national benchmarking concepts, common payer coverage considerations, and coding practice points that affect claim adjudication and reimbursement pathways. Where input data are unavailable, the publication notes that explicit details are not provided.

This summary equips revenue cycle professionals, surgical departments, and policy analysts with a clear understanding of what CPT code 47760 represents, why it matters in clinical and billing workflows, and which payers are typically involved in coverage and payment discussions.

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Billing Code Overview

CPT code 47760 describes a surgical procedure that creates an external connection between the biliary ducts outside the liver and the small intestine to restore bile flow in the setting of biliary obstruction, most commonly due to a tumor. This procedure is a form of biliary-enteric bypass intended to bypass an obstruction and permit passage of bile into the gastrointestinal tract.

Service type: Surgical biliary bypass / biliary-enteric anastomosis
Typical site of service: Operating room or surgical suite within an acute care hospital; may also occur in specialty surgical centers equipped for major abdominal operations

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CPT 47760: Biliary-Enteric Bypass for Biliary Obstruction

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Billing Code Overview

Service type: Surgical biliary bypass / biliary-enteric anastomosis
Typical site of service: Operating room or surgical suite within an acute care hospital; may also occur in specialty surgical centers equipped for major abdominal operations

Clinical & Coding Specifications

Clinical Context

A typical patient is an older adult presenting with progressive jaundice, pruritus, clay-colored stools, and unintended weight loss. Imaging (ultrasound, CT or MRI) demonstrates extrahepatic biliary obstruction most commonly due to a hilar cholangiocarcinoma or pancreatic head malignancy. Endoscopic retrograde cholangiopancreatography (ERCP) with stent placement may be attempted first; when endoscopic or percutaneous decompression is not feasible or has failed, the surgical team performs a surgical biliary-enteric bypass — connecting the extrahepatic biliary ducts to the jejunum (hepaticojejunostomy or choledochojejunostomy) to re-establish bile flow. The procedure typically occurs in an operating room under general anesthesia with an attending hepatobiliary or general surgeon, nursing staff, and intraoperative anesthesia team. Preoperative workflow includes liver function testing, coagulation assessment, cross-sectional imaging, and multidisciplinary discussion with oncology when tumor-directed therapy is planned. Postoperative care includes monitoring for bile leak, infection, bilirubin trends, pain control, and staged transition from intravenous to oral intake before discharge to home or skilled nursing when needed.

Coding Specifications

Modifier	Description	When to Use
`11`	Professional component	When reporting the surgeon's professional service distinct from facility charges — typically facility bills under institutional billing, so rarely appended to the facility claim.
`22`	Increased procedural services	For unusually complex biliary-enteric anastomosis requiring significantly greater work, with documentation supporting increased effort and time.
`23`	Unusual anesthesia	When substantial anesthesia was required for physiological conditions not normally present (use per payer rules).
`52`	Reduced services	When the procedure is started but not completed or only partially performed and documentation supports reduced service.
`53`	Discontinued procedure	If the operation is terminated due to extenuating circumstances prior to completion (e.g., intraoperative instability).
`59`	Distinct procedural service	When a separate, distinct procedure is performed in a different anatomical site or session not usually reported together; use with caution and documentation.
`62`	Two surgeons	When two surgeons with distinct skills perform portions of the biliary bypass intraoperatively (primary surgeon and assistant with separate specialty).
`66`	Surgical team (multiple surgeons)	For services performed by a surgical team when required by complexity or institutional policy.
`78`	Return to operating room for related procedure during global period	For a related reoperation during the global period for complications such as bile leak that require re-exploration.
`79`	Unrelated procedure or service by the same physician during the postoperative period	If an unrelated procedure is performed during the global period (not commonly applicable).
`80`	Assistant surgeon	When an assistant surgeon is documented and billed separately for portions of the operation.
`81`	Minimum assistant surgeon	If a minimum assistant surgeon service is furnished and meets payer criteria.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant	When an advanced practice clinician serves as an assistant where allowed by payer policy.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures	When reporting anesthesia direction consistent with CMS policy (relevant to intraoperative anesthesia coding).

Taxonomy Code	Specialty	Notes
207P00000X	Surgery - General	General surgeons commonly perform biliary-enteric bypass in malignant obstruction.
208000000X	Surgery - Colon & Rectal	Colorectal surgeons may be involved in complex abdominal reconstructions or when bowel mobilization is needed.
208600000X	Surgery - Thoracic & Cardiovascular	Thoracic surgeons occasionally participate for proximal biliary or hepatopancreatobiliary cases involving complex thoracoabdominal approaches.
207L00000X	Surgery - Vascular	Vascular surgeons may assist when vascular control or reconstruction is required in complex tumor resections.
2080S0122X	Surgery - Hepatobiliary (surgical oncology)	Hepatobiliary or surgical oncology specialists frequently perform hepaticojejunostomy/choledochojejunostomy procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C24.0`	Malignant neoplasm of extrahepatic bile ducts	Primary indication when tumor obstructs extrahepatic biliary tree requiring bypass.
`C25.0`	Malignant neoplasm of head of pancreas	Pancreatic head tumors commonly cause distal bile duct obstruction managed with bypass if endoscopic stenting is not feasible.
`C78.7`	Secondary malignant neoplasm of liver and intrahepatic bile duct	Metastatic disease causing biliary obstruction may necessitate bypass for palliation.
`K83.1`	Obstruction of bile duct	General obstructive diagnosis when etiology may be benign or malignant, prompting bypass when other measures fail.
`K83.0`	Cholangitis	Acute or chronic cholangitis secondary to obstruction may require biliary drainage or bypass for source control.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`47562`	Laparoscopic cholecystectomy	May be performed prior to or concurrently when gallbladder removal is indicated during biliary surgery.
`47563`	Laparoscopic cholecystectomy with cholangiography	Used when intraoperative cholangiography is performed to delineate biliary anatomy during bypass planning.
`47579`	Partial hepatectomy, lobectomy (open)	Performed when tumor resection of the liver is required in conjunction with biliary reconstruction.
`43260`	Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy	Frequently attempted prior to surgical bypass for biliary decompression or stent placement; failure may lead to surgical bypass.
`49440`	Percutaneous transhepatic cholangiography and drainage	A percutaneous decompression option that may be performed before or instead of a surgical biliary-enteric bypass.

CPT 47720: Biliary-Enteric Anastomosis (Gallbladder to Small Intestine)

CPT-47721-BILIARY-AND-GASTRIC-BYPASS-ANASTOMOSIS

CPT 47721: Biliary and Gastric Bypass (Anastomoses)

CPT-47740-CHOLECYSTOENTEROSTOMY-BILIARY-BYPASS

CPT 47740: Cholecystoenterostomy (Biliary Bypass)

CPT-47741-BILIARY-AND-GASTROENTERIC-BYPASS-ANASTOMOSIS

CPT 47741: Combined Biliary and Gastroenteric Bypass Anastomosis

CPT-47765-BILIARY-ENTERIC-ANASTOMOSIS-SURGICAL-DRAINAGE

CPT 47765: Biliary-Enteric Anastomosis, Surgical Biliary Drainage

CPT-47780-BILIARY-ENTERIC-ANASTOMOSIS-BYPASS

CPT 47780: Biliary-Enteric Anastomosis to Restore Bile Flow

CPT-47785-JEJUNUM-TO-INTRAHEPATIC-BILIARY-ANASTOMOSIS

CPT 47785: Jejunum to Intrahepatic Biliary Duct Anastomosis

CPT-47800-EXTRAHEPATIC-BILIARY-DUCT-RECONSTRUCTION

CPT 47800: Reconstruction of Extrahepatic Biliary Ducts

CPT-47801-BILIARY-STENT-INSERTION

CPT 47801: Insertion of Biliary Stent

CPT-47900-EXTRAHEPATIC-BILIARY-DUCT-REPAIR

CPT 47900: Repair of Extrahepatic Biliary Duct, Suture

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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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.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`11`	Professional component	When reporting the surgeon's professional service distinct from facility charges — typically facility bills under institutional billing, so rarely appended to the facility claim.
`22`	Increased procedural services	For unusually complex biliary-enteric anastomosis requiring significantly greater work, with documentation supporting increased effort and time.
`23`	Unusual anesthesia	When substantial anesthesia was required for physiological conditions not normally present (use per payer rules).
`52`	Reduced services	When the procedure is started but not completed or only partially performed and documentation supports reduced service.
`53`	Discontinued procedure	If the operation is terminated due to extenuating circumstances prior to completion (e.g., intraoperative instability).
`59`	Distinct procedural service	When a separate, distinct procedure is performed in a different anatomical site or session not usually reported together; use with caution and documentation.
`62`	Two surgeons	When two surgeons with distinct skills perform portions of the biliary bypass intraoperatively (primary surgeon and assistant with separate specialty).
`66`	Surgical team (multiple surgeons)	For services performed by a surgical team when required by complexity or institutional policy.
`78`	Return to operating room for related procedure during global period	For a related reoperation during the global period for complications such as bile leak that require re-exploration.
`79`	Unrelated procedure or service by the same physician during the postoperative period	If an unrelated procedure is performed during the global period (not commonly applicable).
`80`	Assistant surgeon	When an assistant surgeon is documented and billed separately for portions of the operation.
`81`	Minimum assistant surgeon	If a minimum assistant surgeon service is furnished and meets payer criteria.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant	When an advanced practice clinician serves as an assistant where allowed by payer policy.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures	When reporting anesthesia direction consistent with CMS policy (relevant to intraoperative anesthesia coding).

Taxonomy Code	Specialty	Notes
207P00000X	Surgery - General	General surgeons commonly perform biliary-enteric bypass in malignant obstruction.
208000000X	Surgery - Colon & Rectal	Colorectal surgeons may be involved in complex abdominal reconstructions or when bowel mobilization is needed.
208600000X	Surgery - Thoracic & Cardiovascular	Thoracic surgeons occasionally participate for proximal biliary or hepatopancreatobiliary cases involving complex thoracoabdominal approaches.
207L00000X	Surgery - Vascular	Vascular surgeons may assist when vascular control or reconstruction is required in complex tumor resections.
2080S0122X	Surgery - Hepatobiliary (surgical oncology)	Hepatobiliary or surgical oncology specialists frequently perform hepaticojejunostomy/choledochojejunostomy procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C24.0`	Malignant neoplasm of extrahepatic bile ducts	Primary indication when tumor obstructs extrahepatic biliary tree requiring bypass.
`C25.0`	Malignant neoplasm of head of pancreas	Pancreatic head tumors commonly cause distal bile duct obstruction managed with bypass if endoscopic stenting is not feasible.
`C78.7`	Secondary malignant neoplasm of liver and intrahepatic bile duct	Metastatic disease causing biliary obstruction may necessitate bypass for palliation.
`K83.1`	Obstruction of bile duct	General obstructive diagnosis when etiology may be benign or malignant, prompting bypass when other measures fail.
`K83.0`	Cholangitis	Acute or chronic cholangitis secondary to obstruction may require biliary drainage or bypass for source control.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`47562`	Laparoscopic cholecystectomy	May be performed prior to or concurrently when gallbladder removal is indicated during biliary surgery.
`47563`	Laparoscopic cholecystectomy with cholangiography	Used when intraoperative cholangiography is performed to delineate biliary anatomy during bypass planning.
`47579`	Partial hepatectomy, lobectomy (open)	Performed when tumor resection of the liver is required in conjunction with biliary reconstruction.
`43260`	Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy	Frequently attempted prior to surgical bypass for biliary decompression or stent placement; failure may lead to surgical bypass.
`49440`	Percutaneous transhepatic cholangiography and drainage	A percutaneous decompression option that may be performed before or instead of a surgical biliary-enteric bypass.

CPT 47720: Biliary-Enteric Anastomosis (Gallbladder to Small Intestine)

CPT-47721-BILIARY-AND-GASTRIC-BYPASS-ANASTOMOSIS

CPT 47721: Biliary and Gastric Bypass (Anastomoses)

CPT-47740-CHOLECYSTOENTEROSTOMY-BILIARY-BYPASS

CPT 47740: Cholecystoenterostomy (Biliary Bypass)

CPT-47741-BILIARY-AND-GASTROENTERIC-BYPASS-ANASTOMOSIS

CPT 47741: Combined Biliary and Gastroenteric Bypass Anastomosis

CPT-47765-BILIARY-ENTERIC-ANASTOMOSIS-SURGICAL-DRAINAGE

CPT 47765: Biliary-Enteric Anastomosis, Surgical Biliary Drainage

CPT-47780-BILIARY-ENTERIC-ANASTOMOSIS-BYPASS

CPT 47780: Biliary-Enteric Anastomosis to Restore Bile Flow

CPT-47785-JEJUNUM-TO-INTRAHEPATIC-BILIARY-ANASTOMOSIS

CPT 47785: Jejunum to Intrahepatic Biliary Duct Anastomosis

CPT-47800-EXTRAHEPATIC-BILIARY-DUCT-RECONSTRUCTION

CPT 47800: Reconstruction of Extrahepatic Biliary Ducts

CPT-47801-BILIARY-STENT-INSERTION

CPT 47801: Insertion of Biliary Stent

CPT-47900-EXTRAHEPATIC-BILIARY-DUCT-REPAIR

CPT 47900: Repair of Extrahepatic Biliary Duct, Suture

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 47760: Biliary-Enteric Bypass for Biliary Obstruction

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Billing Code Overview

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CPT 47760: Biliary-Enteric Bypass for Biliary Obstruction

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 47760: Biliary-Enteric Bypass for Biliary Obstruction

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Billing Code Overview

CPT 47760: Biliary-Enteric Bypass for Biliary Obstruction

Sign up for cpt 47760 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 47760 describe and who typically performs this procedure?

When is a biliary-enteric bypass (CPT 47760) indicated versus endoscopic or percutaneous drainage?

Which billing modifiers are commonly associated with CPT 47760 and when should they be considered?

What related procedures and CPT codes should coders be aware of when billing for CPT 47760?

Which payers are covered in this publication and does it include reimbursement rates or payer-specific coverage rules?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 47760 describe and who typically performs this procedure?

When is a biliary-enteric bypass (CPT 47760) indicated versus endoscopic or percutaneous drainage?

Which billing modifiers are commonly associated with CPT 47760 and when should they be considered?

What related procedures and CPT codes should coders be aware of when billing for CPT 47760?

Which payers are covered in this publication and does it include reimbursement rates or payer-specific coverage rules?

References