Summary & Overview
CPT 47801: Insertion of Biliary Stent
CPT code 47801 represents the insertion of a stent into the bile duct, an interventional biliary procedure performed to relieve ductal obstruction. Nationally, this code is relevant across acute care and ambulatory surgical settings because biliary stenting is a common therapeutic intervention for obstructive jaundice, choledocholithiasis complications, and malignant biliary strictures. The procedure carries implications for hospital resource use, endoscopy and interventional radiology service lines, and post-procedure care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context for biliary stenting, typical sites of service, and payer coverage considerations. The publication summarizes common billing modifiers and operational notes, and provides benchmarks where available. It also highlights policy and coding considerations that affect claim adjudication and reimbursement across major national payers.
This summary equips clinicians, coding professionals, and revenue cycle staff with the core facts about CPT code 47801, clarifies the clinical intent of the service, and orients readers to the payer landscape and topics addressed in the full publication. Data not available in the input are noted where applicable in detailed sections.
Billing Code Overview
CPT code 47801 describes the insertion of a stent into the bile duct. This procedure involves placing a tubular device to maintain patency of the biliary ductal system, typically to relieve obstruction from strictures, stones, or malignancy.
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Service type: Interventional biliary procedure
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Typical site of service: Hospital outpatient department or inpatient operating room where endoscopic or percutaneous biliary interventions are performed
Clinical & Coding Specifications
Clinical Context
A 64-year-old patient presents with progressive jaundice, right upper quadrant pain, and pruritus. Laboratory tests show cholestatic liver enzyme pattern with elevated bilirubin. Imaging (abdominal ultrasound and MRCP) demonstrates a distal common bile duct stricture suspicious for malignant obstruction from pancreatic head mass. The gastroenterology team schedules endoscopic retrograde cholangiopancreatography (ERCP) with placement of a biliary stent to relieve obstruction. In the procedure suite, the patient undergoes conscious sedation administered by anesthesia; endoscopist performs ERCP, cannulates the bile duct, performs limited balloon dilation of the stricture, and deploys a self-expanding metal stent across the obstructing lesion. Post-procedure, the patient is observed in recovery for vital sign stability and monitored for post-ERCP pancreatitis, bleeding, or infection before discharge with outpatient follow-up for oncology and/or surgical evaluation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician interpretation or professional portion of a technical service is billed separately (rare for this procedure). |
50 | Bilateral procedure |