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See a sample rate comparisonHealthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision UB |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 47556 |
| Medicaid Fee Schedule | View Medicaid rates for 47556 |
National average reimbursement for CPT 47556 by major payers:

$513.89

$544.57

$543.21

$630.71
Choose a payer to see a sample of rates for CPT 47556.
Princess Anne Ambulatory Surgery Management, LLC
Bluegrass Specialty Surgery Center, LLC
Westside Gi Center, LLC
Tallahassee Neurosugery Pain Management LLC
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 47556 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47556 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 47556 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 |
|---|---|---|
| 47550-CPT | Moderate | Bile Duct Exam With Scope, An Exam Of The Bile Ducts Using A Scope (Endoscope). The Procedure May Be Done During A Surgery And Cells May Be Collected. |
| 47552-CPT | Moderate | Biliary Endoscopy Percutaneous Via T-Tube Or Other Tract; Diagnostic With Collection Of Specimen(S) By Brushing And/Or Washing When Performed (Separate Procedure) (Revised 01/01/2014) |
| 47553-CPT | Moderate | Biopsy Of Bile Duct, An Exam Of The Bile Duct Using A Scope (Endoscope). The Procedure Removes A Sample Of Tissue For Testing (Biopsy). |
| 47556-CPT | Moderate | Bile Duct Exam With Scope, An Exam Of The Bile Ducts Using A Scope (Endoscope Through An Existing Tube Or Tract). The Procedure Includes Widening A Portion Of The Duct. A Support Device (Stent) May Be Implanted. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47556. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47556 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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