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CPT code 47000: Liver biopsy, percutaneous needle2026 Medicare rate & RVUs in Puerto Rico

Reports percutaneous needle sampling of liver tissue for diagnostic evaluation, performed by a physician in an office, outpatient, or hospital setting.

CMS RVU26DEffective Oct 1, 2026One payment locality42.9K Medicare services in 2024

In Puerto Rico, Medicare pays $290.34 for 47000 in the office and $76.59 when it’s performed in a hospital or facility.

$290.34Office (non-facility)
$76.59Hospital or facility
+0.8%vs the national office rate ($287.92)

Check a contract rate as a % of Medicare · 47000 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 47000 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 47000 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 47000 covers

A physician passes a biopsy needle through the skin into the liver to obtain tissue for diagnostic examination. Gastroenterologists, hepatologists, radiologists, and other physicians may perform the procedure, often in an outpatient department or hospital; some biopsies are performed in an office. The service is distinct from obtaining a wedge specimen during open surgery. The specimen is submitted for pathological examination, and imaging guidance may be used when clinically indicated.

Report 47000 for the percutaneous needle biopsy itself. The procedure note should support the liver as the sampled site, the percutaneous approach, and tissue acquisition; document guidance separately when performed. Pathological examination of the tissue is a separate service when performed and reportable. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Puerto Rico compares for 47000

Across 109 of 109 payment localities, the office rate for 47000 runs from $252.95 in Arkansas to $392.18 in San Benito County, CA. Puerto Rico pays $290.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

47000 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$290.34
  2. Los Angeles, CA · California$330.02+$39.68
  3. Washington, DC area · District of Columbia$332.13+$41.79
  4. Miami, FL · Florida$305.96+$15.62
  5. Chicago, IL · Illinois$296.79+$6.45
  6. Manhattan, NY · New York$331.70+$41.36
  7. Alaska · Alaska$327.10+$36.76

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

47000 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$256.89$71.89
ArkansasArkansas$252.95$71.33
ArizonaArizona$280.02$75.14
Bakersfield, CACalifornia$308.65$76.92
Chico, CACalifornia$308.13$76.40
El Centro, CACalifornia$308.16$76.43
Fresno, CACalifornia$308.13$76.40
Hanford, CACalifornia$308.13$76.40

47000 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$252.95

$350.16

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
47000 office rate range by state
State / territoryOffice rate rangeLocalities
AK$327.101
AL$256.891
AR$252.951
AZ$280.021
CA$308.13–$392.1829
CO$301.941
CT$307.781
DC$332.131
DE$284.871
FL$280.72–$305.963
GA$264.33–$292.872
GU$316.821
HI$316.821
IA$265.071
ID$266.651
IL$271.24–$298.844
IN$268.321
KS$263.171
KY$262.071
LA$261.40–$275.212
MA$299.73–$333.822
MD$290.73–$332.133
ME$267.49–$283.762
MI$268.77–$283.812
MN$290.541
MO$256.24–$276.963
MS$254.681
MT$287.901
NC$270.561
ND$284.541
NE$266.791
NH$296.571
NJ$311.64–$328.242
NM$270.091
NV$287.201
NY$274.81–$339.405
OH$268.081
OK$262.201
OR$285.32–$312.682
PA$268.87–$299.352
PR$290.341
RI$295.861
SC$269.701
SD$284.151
TN$264.501
TX$266.95–$300.638
UT$273.631
VA$282.36–$332.132
VI$290.341
VT$282.831
WA$299.37–$341.432
WI$274.391
WV$260.431
WY$286.441

See 47000 in every payment locality

How the 47000 rate is calculated

Each of 47000’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 47000

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.61

1.61 RVUs× 1.000 GPCI

Practice expense6.84

6.84 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

8.6200

Conversion factor

$33.4009

Medicare rate

$287.92

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,644

Code
47000
Physician work
1.61
Practice expense
6.84
Malpractice
0.17

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 47000 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.61× 1.0001.6100
Practice expense6.84× 1.0116.9152
Malpractice0.17× 0.9850.1675
Total RVUs8.6927
Conversion factor× 33.4009

Office rate, Puerto Rico$290.34

Office: (1.61 × 1 + 6.84 × 1.011 + 0.17 × 0.985) × $33.4009 = $290.34

Facility: (1.61 × 1 + 0.51 × 1.011 + 0.17 × 0.985) × $33.4009 = $76.59

Open 47000 in the RVU calculator

Payment rules and modifiers for 47000

The CMS indicators that decide how 47000 is paid alongside other services.

CMS payment indicators · 47000

Liver biopsy, percutaneous needle

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

47000 without 51 · national office

$287.92

Liver biopsy, percutaneous needle

47000-51 · Second procedure: 50%

$143.96

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 47000

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 47000
CodeHow it relatesOffice range, Puerto Rico
Same family
47001Liver biopsy, during another major procedureNeedle liver biopsy performed for an indicated purpose during another major procedure.No office rate
Used instead
47100Liver biopsy, wedge tissue sampleWedge liver tissue sampling rather than percutaneous needle sampling.No office rate
Often billed with
88307Tissue pathology exam, level V specimenPathological examination code for a needle liver biopsy specimen.$280.32
76942Ultrasound needle guidance, biopsy, aspiration, injection, or localizationUltrasound guidance for needle placement when separately performed and documented.$64.56

How 47000 has changed in Puerto Rico

47000 · Office / nonfacility

$290.34

Effective 2026-10-01

The base rate is $4.53 higher than on 2025-10-01, moving from $285.81 to $290.34 (1.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $285.81changed to$290.34

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.65 changed to 1.61
    • Practice expense RVU 6.98 changed to 6.84
    • Malpractice RVU 0.16 changed to 0.17
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $298.81changed to$285.81

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.11 changed to 6.98
    • Malpractice RVU 0.17 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $293.94changed to$298.81

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $310.25changed to$293.94

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.28 changed to 7.11
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $308.37changed to$310.25

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $320.01changed to$308.37

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.40 changed to 7.28
    • Malpractice RVU 0.14 changed to 0.17
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $326.88changed to$320.01

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.51 changed to 7.40
    • Malpractice RVU 0.15 changed to 0.14

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $321.38changed to$326.88

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.07 changed to 7.51
    • Malpractice RVU 0.13 changed to 0.15
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $315.95changed to$321.38

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.92 changed to 7.07
    • Malpractice RVU 0.15 changed to 0.13
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $315.24changed to$315.95

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.91 changed to 6.92

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $274.65changed to$315.24

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.90 changed to 6.91
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $278.31changed to$274.65

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.90 changed to 1.65
    • Practice expense RVU 8.26 changed to 6.90
    • Malpractice RVU 0.17 changed to 0.15
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $279.53changed to$278.31

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.19 changed to 0.17

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $278.13changed to$279.53

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $271.94changed to$278.13

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.15 changed to 8.26
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $272.33changed to$271.94

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.93 changed to 8.15
    • Malpractice RVU 0.20 changed to 0.19
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $272.33

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$290.34$76.59RVU26D
2026-07-01$290.34$76.59RVU26C
2026-04-01$290.34$76.59RVU26B
2026-01-01$290.34$76.59RVU26A
2025-10-01$285.81$83.86RVU25D
2025-07-01$285.81$83.86RVU25C
2025-04-01$285.81$83.86RVU25B
2025-01-01$285.81$83.86RVU25A
2024-10-01$298.81$85.96RVU24D
2024-07-01$298.81$85.96RVU24C
2024-04-01$298.81$85.96RVU24B
2024-03-09$298.81$85.96RVU24AR
2024-01-01$293.94$84.55RVU24A
2023-10-01$310.25$87.88RVU23D
2023-07-01$308.37$87.77RVU23C
2023-04-01$308.37$87.77RVU23B
2023-01-01$308.37$87.77RVU23A
2022-10-01$320.01$88.39RVU22D
2022-07-01$320.01$88.39RVU22C
2022-04-01$320.01$88.39RVU22B
2022-01-01$320.01$88.39RVU22A
2021-10-01$326.88$89.47RVU21D
2021-07-01$326.88$89.47RVU21C
2021-04-01$326.88$89.47RVU21B
2021-01-01$326.88$89.47RVU21A
2020-10-01$321.38$92.56RVU20D
2020-07-01$321.38$92.56RVU20C
2020-04-01$321.38$92.56RVU20B
2020-01-01$321.38$92.56RVU20A
2019-10-01$315.95$93.12RVU19D
2019-07-01$315.95$93.12RVU19C
2019-04-01$315.95$93.12RVU19B
2019-01-01$315.95$93.12RVU19A
2018-10-01$315.24$93.38RVU18D
2018-07-01$315.24$93.38RVU18C
2018-04-01$315.24$93.38RVU18B
2018-01-01$315.24$93.38RVU18AR1
2017-10-01$274.65$87.56RVU17D
2017-07-01$274.65$87.56RVU17C
2017-04-01$274.65$87.56RVU17B
2017-01-01$274.65$87.56RVU17A
2016-10-01$278.31$92.78RVU16D
2016-07-01$278.31$92.78RVU16C
2016-04-01$278.31$92.78RVU16B
2016-01-01$278.31$92.78RVU16A
2015-10-01$279.53$93.33RVU15D
2015-07-01$279.53$93.33RVU15C
2015-04-01$278.13$92.86RVU15B
2015-01-01$278.13$92.86RVU15A
2014-10-01$271.94$92.47RVU14D
2014-07-01$271.94$92.47RVU14C
2014-04-01$271.94$92.47RVU14B
2014-01-01$271.94$92.47RVU14A
2013-10-01$272.33$88.25RVU13D
2013-07-01$272.33$88.25RVU13C
2013-04-01$272.33$88.25RVU13B
2013-01-01$272.33$88.25RVU13AR

Price 47000 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

47000 billing questions

When should 47000 be used instead of 47001?

Use 47000 for a percutaneous needle biopsy performed as a standalone procedure. Code 47001 describes a needle biopsy performed for an indicated purpose during another major procedure.

Is liver pathology included in 47000?

The biopsy code represents tissue acquisition, not the pathologist's examination. A separately performed, reportable examination of a needle liver biopsy specimen may be reported with 88307.

Can modifier 50 be used for a biopsy of both liver lobes?

No. Modifier 50 is inappropriate for 47000, even if sampling involves more than one liver area.

How does the multiple-procedure reduction affect 47000?

When other procedures are performed in the same session, Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the others.

What documentation supports reporting 47000?

Document the clinical reason for sampling, the liver as the site, the percutaneous needle approach, and that tissue was obtained. Record imaging guidance separately when used.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 47000PPRRVU2026_Oct_nonQPP.csv, line 5,644 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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