2025 CPT code 47554
(Active) Effective Date: N/A Revision Date: N/A Surgery - Endoscopy Procedures on the Biliary Tract Surgery Feed
Percutaneous biliary endoscopy via T-tube or other tract, with stone removal.
Modifiers may be applicable depending on the circumstances, such as 59 (distinct procedural service) or other modifiers addressing multiple procedures, anesthesia, or reduced services.Consult the official CPT manual for appropriate modifier selection.
Medical necessity for 47554 is established by the presence of symptomatic or clinically significant biliary obstruction, typically demonstrated by imaging studies such as ultrasound, CT scan, or MRCP.The presence of retained calculi causing symptoms (e.g., jaundice, abdominal pain, fever) necessitates their removal to improve the patient's condition.
The physician is responsible for pre-operative preparation, insertion of the choledochoscope, examination of the biliary ducts (potentially using fluoroscopy and/or cholangiography), removal of calculi, and post-procedure care.
In simple words: The doctor uses a thin, flexible tube with a camera and light to look inside the bile ducts.This tube is inserted through an existing tube in the belly.If any stones are found, they are removed through the tube.
This procedure involves the use of a biliary endoscope (choledochoscope) inserted percutaneously through a pre-existing T-tube or other tract (e.g., percutaneous transhepatic drainage tube) into the biliary ducts.The scope allows visualization of the ducts to identify blockages and the retrieval of one or more calculi (stones). Fluoroscopic guidance and/or cholangiography (dye injection) may be used for enhanced visualization.Following stone removal, all instruments are withdrawn, and the choledochoscope is removed.
Example 1: A patient with a history of choledocholithiasis (gallstones in the common bile duct) undergoes percutaneous transhepatic cholangiography (PTC) with placement of a drainage tube.A subsequent procedure is performed using code 47554 to remove gallstones via the existing drainage tube., A patient with a T-tube in place after cholecystectomy (gallbladder removal) experiences biliary obstruction.Code 47554 is used to perform biliary endoscopy and remove the obstructing stone via the T-tube., A patient presents with recurrent cholangitis (inflammation of the bile ducts).Following placement of a percutaneous drainage catheter, code 47554 is applied for endoscopic stone removal and biliary duct clearance.
* Pre-operative assessment and diagnosis (including imaging studies demonstrating choledocholithiasis).* Procedure note detailing the technique, including type of access (T-tube or other tract), fluoroscopy use, cholangiography if performed, number of stones removed, and any complications.* Post-operative assessment and follow-up.* Pathology report if tissue samples were obtained.
** Always check payer-specific guidelines and local coverage determination for reimbursement policies before billing.Ensure all documentation requirements are met for accurate coding and appropriate payment.
- Revenue Code: P8I (ENDOSCOPY - OTHER)
- RVU: Information not available in source. Refer to CMS guidelines and local payer information for RVU values and reimbursement details.
- Global Days : Information not provided in source.The global period will depend on payer policies and may vary.
- Payment Status: Active
- Modifier TC rule: Modifier TC (Technical Component) is not typically applicable to code 47554.However, it's essential to consult local payer guidelines and NCCI edits to verify modifier applicability in specific cases.
- Fee Schedule : Historical fee schedule data is not available in the source.
- Specialties:Gastroenterology, Surgery, Interventional Radiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center