Procedure code and Description
47560 Laparoscopy, surgical; with guided transhepatic cholangiography, without biopsy
47561 with guided transhepatic cholangiography with biopsy
47563 cholecystectomy with cholangiography
47564 cholecystectomy with exploration of common duct
47579 Unlisted laparoscopy procedure, biliary tract
47560, 47561 have been deleted. To report laparoscopically guided transhepatic cholangiograpy with biopsy, use 47579
Select Laparoscopic Cholecystectomy with Common Bile Duct Exploration (CBDE) Procedures
Payer policies will vary and should be verified prior to treatment for limitations on diagnosis, coding or site of service requirements. The coding options listed within this guide are commonly used codes and are not intended to be an all-inclusive list. We recommend consulting your relevant manuals for appropriate coding options.
The following codes are thought to be relevant to Laparoscopic Cholecystectomy with Common Bile Duct Exploration (CBDE) procedures and are referenced throughout this guide.
All rates shown are 2020 Medicare national averages; actual rates will vary geographically and/or by individual facility.
Physician Coding and Payment
Code Description Work Total Facility In-Facility
47564 Laparoscopy, surgical; cholecystectomy with exploration of common duct 18.00 32.48 $1,172
Medicare Hospital Inpatient Payment Rates Effective October 1, 2019 – September 30, 2020
Medicare Severity Diagnosis Related Groups (MS-DRGs) assignment is based on a combination of diagnoses and procedure codes reported. While MS-DRGs listed in this guide represent likely assignments, Boston Scientific cannot guarantee assignment to any one specific MS-DRG. MS-DRGs resulting from inpatient laparoscopic cholecystectomy with common bile duct exploration procedures may include (but are not limited to):
A Whipple-type pancreatectomy procedure (CPT codes 48150-48154) includes removal of the gallbladder. A cholecystectomy (e.g., CPT codes 47562-47564, 47600-47620) shall not be reported separately.
This policy addresses coding and coverage when an operative cholangiography is performed to evaluate the biliary tract and help decide whether or not to explore the common bile duct for stones or other abnormalities.
Operative cholangiography involves the injection of radiopaque contrast material into the cystic or common bile duct during surgery. This procedure is performed to identify various abnormalities of the biliary ductal system, often secondary to stones (calculi or choledocholithiasis) and occasionally other lesions, such as benign strictures or tumors.
Frequently during cholecystectomy, an operative cholangiogram is performed to help the surgeon decide whether or not to explore the common bile duct for stones or other pathologic processes.
When one physician reports the cholecystectomy and operative cholangiography with subsequent common bile duct exploration, the services are combined under the procedure codes 47564 (laparoscopic approach) or 47610 (open/excision approach), as appropriate. If additional surgical procedures are performed during the same operative session, then the modifier 59 may be reported with a non-E/M service, to identify it as distinct or independent from other non-E/M services performed on the same day. When modifier 59 is reported, the patient’s records must support its use in accordance with CPT guidelines.
If, however, a second physician (e.g., a radiologist) provides the formal interpretation of the operative cholangiography, then the service is eligible for coverage under codes 74300-74301 (cholangiography and/or pancreatography).
Documentation/operative report must identify and describe the procedures performed. If a denial is appealed, this documentation must be submitted with the appeal.
Eligible surgical services will be subject to the Blue Cross fee schedule amount. Denied services will be provider liability.
The following applies to all claim submissions.
All coding and reimbursement is are subject to all terms of the Provider Service Agreement and subject to changes, updates, or other requirements of coding rules and guidelines. All codes are subject to federal HIPAA rules, and in the case of medical code sets (HCPCS, CPT, ICD), only codes valid for the date of service may be submitted or accepted. Reimbursement for all Health Services is subject to current Blue Cross Medical Policy criteria, policies found in Provider Policy and Procedure Manual sections, Reimbursement Policies and all other provisions of the Provider Service Agreement (Agreement).
In the event that any new codes are developed during the course of Provider’s Agreement, such new codes will be reimbursed according to the standard or applicable Blue Cross fee schedule until such time as a new agreement is reached and supersedes the Provider’s current Agreement.
All payment for codes based on Relative Value Units (RVU) will include a site of service differential and will be calculated, if appropriate, using the appropriate facility or non-facility components, based on the site of service identified, as submitted by Provider.
The following codes are included below for informational purposes only and are subject to change without notice. Inclusion or exclusion of a code does not constitute or imply member coverage or provider reimbursement.
CPT / HCPCS Modifier: 59
ICD Diagnosis: N/A
ICD Procedure: N/A
HCPCS: 47564, 47610, 74300, 74301
Revenue Codes: N/A
Deleted Codes: N/A
Surgical laparoscopy always includes diagnostic laparoscopy. To report a diagnostic laparoscopy (peritoneoscopy) (separate procedure), use 49320.
47605 with cholangiography (For laparoscopic approach, see 47562-47564)
The five-digit numeric codes and descriptions included in the Medical Reimbursement Schedule are obtained from the Physicians’ Current Procedural Terminology, copyright 1999 by the American Medical Association (CPT). CPT is a listing of descriptive terms and numeric identifying codes and modifiers for reporting medical services and procedures performed by physicians and other health care providers.
This publication includes only CPT numeric identifying codes and modifiers for reporting medical services and procedures that were selected by the Louisiana Department of Labor, Office of Workers’ Compensation. Any use of CPT outside the fee schedule should refer to the Physicians’ Current Procedural Terminology, copyright 1999 American Medical Association and any update thereto. These CPT publications contain the complete and most current listing of CPT descriptive terms and numeric identifying codes and modifiers for reporting medical services and procedures.
No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of the Physicians’ Current Procedural Terminology, copyright 1999, by the American Medical Association. All rights reserved
Maximum Fee Allowance Schedule Office of Workers’ Compensation
CPT Global Maximum
Code Mod Description Days Allowance
47564 Laparo cholecystectomy explr. 90 BR