CPT code 47533: Biliary drainage, external catheter2026 Medicare rate & RVUs in Puerto Rico

Percutaneous placement of an external biliary drainage catheter to divert bile when normal drainage through the biliary tract is impaired.

CMS RVU26DEffective Oct 1, 2026One payment locality1.1K Medicare services in 2024

In Puerto Rico, Medicare pays $1,120.71 for 47533 in the office and $226.86 when it’s performed in a hospital or facility.

$1,120.71Office (non-facility)
$226.86Hospital or facility
+0.9%vs the national office rate ($1,110.91)

Check a contract rate as a % of Medicare · 47533 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 47533 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 47533 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 47533 covers

An interventional radiologist typically places this catheter through the skin and liver into the biliary system, using imaging to guide access and catheter positioning. The external catheter directs bile out of the body into a collection bag, commonly to relieve obstruction from a stricture, stone, or tumor when external drainage is needed. Diagnostic cholangiography and imaging guidance are included when performed, along with the associated radiological supervision and interpretation.

Report 47533 for initial placement of an external drain; use 47534 when the catheter provides internal-external drainage. The record should support the access, catheter placement, drainage approach, and clinical need. The 0-day global includes same-day preoperative and postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and 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 47533

Across 109 of 109 payment localities, the office rate for 47533 runs from $972.45 in Arkansas to $1,526.47 in San Benito County, CA. Puerto Rico pays $1,120.71. The RVUs are the same everywhere; the geographic indexes change the dollars.

47533 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$1,120.71
  2. Los Angeles, CA · California$1,279.43+$158.72
  3. Washington, DC area · District of Columbia$1,285.68+$164.97
  4. Miami, FL · Florida$1,177.60+$56.89
  5. Chicago, IL · Illinois$1,141.38+$20.67
  6. Manhattan, NY · New York$1,281.77+$161.06
  7. Alaska · Alaska$1,249.62+$128.91

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

Every other payment area

47533 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$988.09$214.48
ArkansasArkansas$972.45$212.99
ArizonaArizona$1,079.76$223.05
Bakersfield, CACalifornia$1,194.79$225.79
Chico, CACalifornia$1,193.05$224.05
El Centro, CACalifornia$1,193.14$224.14
Fresno, CACalifornia$1,193.05$224.05
Hanford, CACalifornia$1,193.05$224.05

47533 rates by state

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

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Local rates. Clear comparisons.

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

$972.45

$1,359.76

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

View every state and territory as a table
47533 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,249.621
AL$988.091
AR$972.451
AZ$1,079.761
CA$1,193.05–$1,526.4729
CO$1,167.511
CT$1,188.991
DC$1,285.681
DE$1,098.871
FL$1,080.16–$1,177.603
GA$1,015.59–$1,129.932
GU$1,228.461
HI$1,228.461
IA$1,021.531
ID$1,027.561
IL$1,041.90–$1,151.594
IN$1,034.221
KS$1,013.481
KY$1,007.561
LA$1,004.71–$1,059.432
MA$1,158.43–$1,293.812
MD$1,122.10–$1,285.683
ME$1,030.40–$1,095.642
MI$1,033.63–$1,091.902
MN$1,124.091
MO$983.94–$1,066.963
MS$978.551
MT$1,110.881
NC$1,042.631
ND$1,099.611
NE$1,028.501
NH$1,146.111
NJ$1,204.09–$1,269.902
NM$1,038.671
NV$1,108.651
NY$1,059.43–$1,311.685
OH$1,031.331
OK$1,008.601
OR$1,101.59–$1,210.582
PA$1,034.71–$1,155.322
PR$1,120.711
RI$1,142.431
SC$1,038.401
SD$1,098.271
TN$1,018.701
TX$1,027.08–$1,162.258
UT$1,053.981
VA$1,089.74–$1,285.682
VI$1,120.711
VT$1,092.341
WA$1,157.22–$1,324.252
WI$1,059.251
WV$999.061
WY$1,105.961

See 47533 in every payment locality

How the 47533 rate is calculated

Each of 47533’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 · 47533

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.25

5.25 RVUs× 1.000 GPCI

Practice expense27.44

27.44 RVUs× 1.000 GPCI

Malpractice0.57

0.57 RVUs× 1.000 GPCI

Adjusted RVUs

33.2600

Conversion factor

$33.4009

Medicare rate

$1,110.91

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

5,685

Code
47533
Physician work
5.25
Practice expense
27.44
Malpractice
0.57

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 47533 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work5.25× 1.0005.2500
Practice expense27.44× 1.01127.7418
Malpractice0.57× 0.9850.5614
Total RVUs33.5533
Conversion factor× 33.4009

Office rate, Puerto Rico$1120.71

Office: (5.25 × 1 + 27.44 × 1.011 + 0.57 × 0.985) × $33.4009 = $1120.71

Facility: (5.25 × 1 + 0.97 × 1.011 + 0.57 × 0.985) × $33.4009 = $226.86

Open 47533 in the RVU calculator

Payment rules and modifiers for 47533

The CMS indicators that decide how 47533 is paid alongside other services.

CMS payment indicators · 47533

Biliary drainage, external catheter

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

47533 without 51 · national office

$1,110.91

Biliary drainage, external catheter

47533-51 · Second procedure: 50%

$555.46

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

How 47533 has changed in Puerto Rico

47533 · Office / nonfacility

$1120.71

Effective 2026-10-01

The base rate is $33.46 higher than on 2025-10-01, moving from $1087.25 to $1120.71 (3.1%).

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

    $1087.25changed to$1120.71

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.38 changed to 5.25
    • Practice expense RVU 27.50 changed to 27.44
    • Malpractice RVU 0.55 changed to 0.57
    • 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

    $1146.37changed to$1087.25

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 28.32 changed to 27.50

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1127.66changed to$1146.37

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1202.86changed to$1127.66

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 29.34 changed to 28.32
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982
  5. October 1, 2023

    RVU23D

    $1195.20changed to$1202.86

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984
  6. January 1, 2023

    RVU23A

    $1258.80changed to$1195.20

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 30.26 changed to 29.34
    • Malpractice RVU 0.50 changed to 0.55
    • 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

    $1312.87changed to$1258.80

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 31.52 changed to 30.26
    • Malpractice RVU 0.48 changed to 0.50

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $1300.44changed to$1312.87

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 29.94 changed to 31.52
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $1277.26changed to$1300.44

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 29.38 changed to 29.94
    • 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

    $1267.51changed to$1277.26

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 29.14 changed to 29.38
    • Malpractice RVU 0.49 changed to 0.48

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $1102.80changed to$1267.51

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 29.23 changed to 29.14
    • Malpractice RVU 0.51 changed to 0.49
    • 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

    $1012.85changed to$1102.80

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 6.00 changed to 5.38
    • Practice expense RVU 31.32 changed to 29.23
    • Malpractice RVU 0.71 changed to 0.51
    • 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

    No ratechanged to$1012.85

    Held through RVU16B, RVU16C, RVU16D.

  14. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,120.71$226.86RVU26D
2026-07-01$1,120.71$226.86RVU26C
2026-04-01$1,120.71$226.86RVU26B
2026-01-01$1,120.71$226.86RVU26A
2025-10-01$1,087.25$249.47RVU25D
2025-07-01$1,087.25$249.47RVU25C
2025-04-01$1,087.25$249.47RVU25B
2025-01-01$1,087.25$249.47RVU25A
2024-10-01$1,146.37$254.39RVU24D
2024-07-01$1,146.37$254.39RVU24C
2024-04-01$1,146.37$254.39RVU24B
2024-03-09$1,146.37$254.39RVU24AR
2024-01-01$1,127.66$250.23RVU24A
2023-10-01$1,202.86$261.11RVU23D
2023-07-01$1,195.20$260.93RVU23C
2023-04-01$1,195.20$260.93RVU23B
2023-01-01$1,195.20$260.93RVU23A
2022-10-01$1,258.80$265.33RVU22D
2022-07-01$1,258.80$265.33RVU22C
2022-04-01$1,258.80$265.33RVU22B
2022-01-01$1,258.80$265.33RVU22A
2021-10-01$1,312.87$267.20RVU21D
2021-07-01$1,312.87$267.20RVU21C
2021-04-01$1,312.87$267.20RVU21B
2021-01-01$1,312.87$267.20RVU21A
2020-10-01$1,300.44$278.94RVU20D
2020-07-01$1,300.44$278.94RVU20C
2020-04-01$1,300.44$278.94RVU20B
2020-01-01$1,300.44$278.94RVU20A
2019-10-01$1,277.26$279.24RVU19D
2019-07-01$1,277.26$279.24RVU19C
2019-04-01$1,277.26$279.24RVU19B
2019-01-01$1,277.26$279.24RVU19A
2018-10-01$1,267.51$280.02RVU18D
2018-07-01$1,267.51$280.02RVU18C
2018-04-01$1,267.51$280.02RVU18B
2018-01-01$1,267.51$280.02RVU18AR1
2017-10-01$1,102.80$264.12RVU17D
2017-07-01$1,102.80$264.12RVU17C
2017-04-01$1,102.80$264.12RVU17B
2017-01-01$1,102.80$264.12RVU17A
2016-10-01$1,012.85$277.05RVU16D
2016-07-01$1,012.85$277.05RVU16C
2016-04-01$1,012.85$277.05RVU16B
2016-01-01$1,012.85$277.05RVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 47533 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

47533 billing questions

How does 47533 differ from 47534?

47533 describes an external drainage catheter that directs bile outside the body. Use 47534 for a catheter that drains both externally and internally.

Can diagnostic cholangiography be billed separately with 47533?

Diagnostic cholangiography performed as part of the catheter placement is included in 47533. The code also includes imaging guidance and associated radiological supervision and interpretation.

Is modifier 50 appropriate for bilateral biliary drainage?

No. The descriptor and anatomy make bilateral adjustment inappropriate for 47533.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 47533. Co-surgeons and team surgery are not permitted.

How is 47533 affected when other procedures are performed in the same session?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 47533PPRRVU2026_Oct_nonQPP.csv, line 5,685 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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