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See a sample rate comparisonCPT 47425 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Incision Of Bile Duct, Choledochotomy Or Choledochostomy With Exploration Drainage Or Removal Of Calculus With Or Without Cholecystotomy With Transduodenal Sphincterotomy Or Sphincteroplasty
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 47425 |
| Medicaid Fee Schedule | View Medicaid rates for 47425 |
National average reimbursement for CPT 47425 by major payers:
$1,733.06
$1,809.68
$1,870.35
$2,165.46
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CPT 47425
5 of 25 sample ratesHigher to lower in this preview
Saint Luke'S Surgicenter
Saint Lukes Surgicenter
$2,347.00Published rateMelville Sc LLC, Melville Surgery Center
Melville Surgery Center, LLC
$1,061.00Published rateAesthetic Plastic Surgery Institute Of Louisville, LLC, Louisville Surgery Center
Aesthetic Plastic Surgery Institute
$883.00Published rateHand Asc LLC
$651.00Published rateCoastal Digestive Care Center LLC
$122.00Published rate
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See a sample payer proposalCPT 47425 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47425 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 47425 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 47400-CPT | High | Hepaticotomy Or Hepaticostomy W/ Explora Drain Or Remval, Hepaticotomy Or Hepaticostomy With Exploration Drainage Or Removal O |
| 47420-CPT | High | Incision Of Bile Duct, Choledochotomy Or Choledochostomy With Exploration Drainage Or Removal Of Calculus With Or Without Cholecystotomy Without Transduodenal Sphincterotomy Or Sphincteroplasty |
| 47425-CPT | High | Incision Of Bile Duct, Choledochotomy Or Choledochostomy With Exploration Drainage Or Removal Of Calculus With Or Without Cholecystotomy With Transduodenal Sphincterotomy Or Sphincteroplasty |
| 47562-CPT | Moderate | Laparoscopy; Cholecystectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47425. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47425 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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