2025 CPT code 47544
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Percutaneous removal of calculi or debris from the biliary ducts and/or gallbladder, including destruction of calculi (if performed), imaging guidance, and radiological supervision and interpretation.
Modifiers may be applicable.For example, modifier 59 may be used to indicate a distinct procedural service. Modifier 74 may be used to report the procedure if discontinued after anesthesia administration. Refer to current CPT guidelines for the latest rules about specific modifier applications.
Medical necessity must be established for the primary procedure. The removal of calculi/debris should be a necessary component of that procedure, not incidental.
After the patient is prepared and anesthesia is administered, the physician uses fluoroscopic guidance to insert a needle into the liver, advancing it to the bile duct. A guide wire is then inserted through the needle, followed by a catheter. The physician uses this catheter to extract debris or stones, sometimes crushing larger stones before removal, using tools inserted through the catheter, or through lithotripsy.
In simple words: This procedure involves removing stones or debris from the bile ducts and/or gallbladder through a small incision in the skin.The doctor uses imaging, like a live X-ray video, to guide a small tube into the affected area.If needed, they can also break down larger stones using different techniques before removing them.This code also includes the expert interpretation of the imaging used during the procedure.
Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation. (List separately in addition to code for primary procedure)
Example 1: A patient presents with gallstones obstructing the common bile duct. A percutaneous transhepatic cholangiogram (PTC) is performed (47533), followed by removal of the stones with a basket catheter (47544)., A patient with a history of cholecystectomy experiences recurrent biliary strictures and stone formation. A percutaneous biliary drainage is performed (47534), anddebris is cleared using a balloon catheter to dilate the stricture (47542), followed by stone removal (47544)., During an endoscopic retrograde cholangiopancreatography (ERCP), a stone is unable to be retrieved endoscopically. A percutaneous access is established by a radiologist to assist with removal of the impacted stone (47541), which is further fragmented and removed percutaneously (47544).
Documentation should include details of the primary procedure performed, method of stone/debris removal, type of imaging guidance used, confirmation of non-incidental removal of debris (if applicable), and all associated radiological supervision and interpretation.
** Code 47544 is an add-on code, meaning it cannot be billed independently and must be used in conjunction with a primary procedure code.While the code description mentions destruction of calculi, this destruction is not separately billable and is included within the 47544 code when performed. Ensure documentation clearly supports the medical necessity of the removal of calculi/debris and is not merely incidental.
- Revenue Code: P1G - MAJOR PROCEDURE - OTHER
- Payment Status: Add-on code
- Modifier TC rule: Not applicable.
- Specialties:Interventional Radiology, Gastroenterology, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center