Summary & Overview
CPT 47780: Biliary-Enteric Anastomosis to Restore Bile Flow
CPT code 47780 represents a biliary-enteric anastomosis performed to restore bile flow when the biliary tract is obstructed, commonly by a tumor or stricture. This operative procedure — often performed as an end-to-side or Y-shaped (Roux-en-Y) hepaticojejunostomy or choledochojejunostomy — is an important surgical option for patients with obstructive cholestasis who are not candidates for endoscopic drainage. Nationally, procedures coded with 47780 are relevant to surgical oncology, hepatobiliary surgery, and complex general surgery care patterns, and they carry implications for inpatient resource utilization and postoperative care pathways.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and coding context for 47780, typical sites of service, common billing considerations, and where to look for related procedural or diagnosis coding. The publication summarizes benchmarking and policy-relevant topics such as utilization trends, prior authorization and coverage variability among major payers, and typical postoperative service line implications. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 47780 describes a surgical biliary-enteric anastomosis in which the provider attaches the biliary ducts to the small intestine in an end-to-side or Y-shaped (Roux-en-Y) configuration to restore bile flow obstructed by a biliary tumor or other condition.
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Service type: Open or laparoscopic biliary reconstruction and bypass procedure to reestablish biliary drainage.
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Typical site of service: Hospital operating room or inpatient surgical setting.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 62-year-old with obstructive jaundice, right upper quadrant pain, pruritus, and cholestatic liver enzyme elevation caused by a periampullary or extrahepatic biliary malignancy. Imaging (CT, MRI, or MRCP) demonstrates biliary obstruction with proximal ductal dilation. Endoscopic stenting was attempted or not feasible due to tumor extent, recurrent stent occlusion, or benign stricture failure. The surgical team schedules an open or laparoscopic biliary-enteric reconstruction (Roux-en-Y hepaticojejunostomy) to restore bile flow.
Preoperative workflow includes history/physical, labs (CBC, CMP, coagulation), cross-sectional imaging, anesthesia evaluation, and informed consent documenting risks (bleeding, leak, infection, anesthesia). Intraoperative steps include exposure of hepatic hilum, resection of obstructing lesion if indicated, creation of a Roux limb of jejunum, and creation of an end-to-side or Y-shaped hepaticojejunostomy with meticulous mucosa-to-mucosa anastomosis. Drains may be placed. Postoperative management includes monitoring for bile leak, liver function tests, supportive care, and staged adjuvant oncology referral if malignancy is confirmed.
Typical site of service: Hospital inpatient operating room or ambulatory surgery center when clinically appropriate. Service type: Major surgical/operative biliary reconstruction.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default or no modifier appended |