CPT code 47534: Biliary drainage, internal-external catheter2026 Medicare rate & RVUs
Reports image-guided percutaneous placement of an internal-external biliary drainage catheter, typically to drain an obstructed bile duct through both internal and external routes.
Medicare pays $1,218.13 for 47534 nationally in the office and $316.97 in a hospital or facility. Local office rates run $1,071.85–$1,649.56.
Medicare rate · 47534
Biliary drainage, internal-external catheter
- Work RVUs
- 7.41
- Total RVUs
- 36.47
- Global days
- 000
National rate · 2026
$1,218.13
Office setting, before claim adjustments.
See every locality for 47534 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 10 sections
What 47534 covers
An interventional radiologist or other qualified physician accesses the biliary tree through the skin and liver, evaluates the ducts with cholangiography, and places a catheter that permits bile to drain internally into the bowel and externally through the catheter. This approach may be used for biliary obstruction when drainage across the obstructed segment is feasible and external access is also needed. The service is commonly performed in a hospital imaging or interventional suite.
Report this code for placement of the internal-external drainage catheter, not for an external-only catheter. The service includes diagnostic cholangiography and imaging guidance with associated radiological supervision and interpretation; document the access route, catheter position and drainage configuration. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. 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.
Where 47534 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$1071.85 to $1649.56
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $1,088.34 | $299.83 |
| Alaska | $1,390.89 | $431.16 |
| Arizona | $1,184.95 | $311.73 |
| Arkansas | $1,071.85 | $297.76 |
| Atlanta, GA | $1,239.47 | $323.90 |
| Austin, TX | $1,270.21 | $316.79 |
| Bakersfield, CA | $1,302.68 | $315.01 |
| Baltimore area, MD | $1,297.44 | $330.50 |
| Beaumont, TX | $1,131.29 | $311.24 |
| Brazoria, TX | $1,205.60 | $312.55 |
| Chicago, IL | $1,260.05 | $354.39 |
| Chico, CA | $1,300.18 | $312.51 |
| Colorado | $1,275.47 | $316.64 |
| Connecticut | $1,301.46 | $330.92 |
| Dallas, TX | $1,212.70 | $315.14 |
| Delaware | $1,205.28 | $314.94 |
| Detroit, MI | $1,203.91 | $334.29 |
| East St. Louis, IL | $1,170.44 | $341.38 |
| El Centro, CA | $1,300.32 | $312.65 |
| Fort Lauderdale, FL | $1,252.52 | $339.65 |
| Fort Worth, TX | $1,203.62 | $315.08 |
| Fresno, CA | $1,300.18 | $312.51 |
| Galveston, TX | $1,208.80 | $313.95 |
| Hanford, CA | $1,300.18 | $312.51 |
| Hawaii, Guam, HI | $1,335.82 | $311.21 |
| Houston, TX | $1,223.81 | $328.96 |
| Idaho | $1,128.24 | $299.17 |
| Indiana | $1,135.20 | $299.82 |
| Iowa | $1,121.44 | $296.88 |
| Kansas | $1,113.99 | $299.35 |
| Kentucky | $1,111.10 | $309.98 |
| King County, WA | $1,439.61 | $333.89 |
| Los Angeles, CA | $1,391.69 | $325.62 |
| Madera, CA | $1,300.18 | $312.51 |
| Manhattan, NY | $1,402.83 | $355.68 |
| Marin County, CA | $1,613.56 | $342.92 |
| Merced, CA | $1,300.18 | $312.51 |
| Metropolitan Boston, MA | $1,408.25 | $332.27 |
| Metropolitan Kansas City, MO | $1,159.96 | $313.78 |
| Metropolitan Philadelphia, PA | $1,266.54 | $328.44 |
| Metropolitan St. Louis, MO | $1,172.91 | $315.01 |
| Miami, FL | $1,298.68 | $360.58 |
| Minnesota | $1,226.20 | $298.91 |
| Mississippi | $1,079.87 | $303.98 |
| Modesto, CA | $1,300.18 | $312.51 |
| Montana | $1,218.08 | $316.92 |
| Napa, CA | $1,520.20 | $332.47 |
| Nebraska | $1,128.47 | $296.70 |
| Nevada | $1,214.50 | $312.44 |
| New Hampshire | $1,253.38 | $315.28 |
| New Mexico | $1,145.35 | $318.99 |
| New Orleans, LA | $1,166.20 | $318.22 |
| North Carolina | $1,145.05 | $304.27 |
| North Dakota | $1,201.86 | $300.71 |
| Northern New Jersey | $1,386.50 | $341.16 |
| NYC suburbs and Long Island, NY | $1,435.72 | $364.24 |
| Ohio | $1,136.29 | $313.53 |
| Oklahoma | $1,111.10 | $306.36 |
| Oxnard, CA | $1,386.41 | $321.24 |
| Portland, OR | $1,319.78 | $318.59 |
| Poughkeepsie and northern NYC suburbs, NY | $1,324.63 | $337.86 |
| Puerto Rico | $1,228.10 | $317.03 |
| Queens, NY | $1,417.75 | $352.58 |
| Redding, CA | $1,300.18 | $312.51 |
| Rest of California | $1,300.18 | $312.51 |
| Rest of Florida | $1,190.40 | $328.90 |
| Rest of Georgia | $1,121.52 | $317.69 |
| Rest of Illinois | $1,151.49 | $328.73 |
| Rest of Louisiana | $1,108.51 | $310.98 |
| Rest of Maine | $1,132.32 | $303.25 |
| Rest of Maryland | $1,229.68 | $317.71 |
| Rest of Massachusetts | $1,266.52 | $317.61 |
| Rest of Michigan | $1,139.60 | $316.85 |
| Rest of Missouri | $1,087.25 | $310.45 |
| Rest of New Jersey | $1,317.47 | $333.40 |
| Rest of New York | $1,162.83 | $306.74 |
| Rest of Oregon | $1,206.22 | $308.67 |
| Rest of Pennsylvania | $1,139.28 | $312.02 |
| Rest of Texas | $1,167.37 | $312.17 |
| Rest of Washington | $1,264.79 | $315.88 |
| Rhode Island | $1,251.00 | $320.11 |
| Riverside, CA | $1,309.11 | $321.44 |
| Sacramento, CA | $1,368.08 | $320.04 |
| Salinas, CA | $1,363.07 | $318.63 |
| San Benito County, CA | $1,649.56 | $350.09 |
| San Diego, CA | $1,397.89 | $320.10 |
| San Francisco, CA | $1,612.62 | $341.99 |
| San Luis Obispo, CA | $1,340.74 | $314.32 |
| Santa Clara County, CA | $1,645.75 | $346.29 |
| Santa Cruz, CA | $1,413.42 | $318.51 |
| Santa Maria, CA | $1,368.93 | $318.18 |
| Santa Rosa, CA | $1,427.91 | $321.29 |
| South Carolina | $1,142.34 | $309.67 |
| South Dakota | $1,199.94 | $298.79 |
| Southern Maine, ME | $1,199.54 | $306.49 |
| Stockton, CA | $1,300.18 | $312.51 |
| Suburban Chicago, IL | $1,266.47 | $340.99 |
| Tennessee | $1,119.61 | $300.46 |
| Utah | $1,158.74 | $311.66 |
| Vallejo, CA | $1,518.86 | $331.13 |
| Vermont | $1,195.17 | $303.02 |
| Virgin Islands, VI | $1,228.10 | $317.03 |
| Virginia | $1,194.04 | $308.21 |
| Visalia, CA | $1,300.18 | $312.51 |
| Washington, DC area | $1,402.49 | $340.93 |
| West Virginia | $1,106.37 | $323.27 |
| Wisconsin | $1,159.56 | $296.25 |
| Wyoming | $1,211.01 | $309.85 |
| Yuba City, CA | $1,300.18 | $312.51 |
47534 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$1,071.85
$1,474.87
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $1,390.89 | 1 |
| AL | $1,088.34 | 1 |
| AR | $1,071.85 | 1 |
| AZ | $1,184.95 | 1 |
| CA | $1,300.18–$1,649.56 | 29 |
| CO | $1,275.47 | 1 |
| CT | $1,301.46 | 1 |
| DC | $1,402.49 | 1 |
| DE | $1,205.28 | 1 |
| FL | $1,190.40–$1,298.68 | 3 |
| GA | $1,121.52–$1,239.47 | 2 |
| GU | $1,335.82 | 1 |
| HI | $1,335.82 | 1 |
| IA | $1,121.44 | 1 |
| ID | $1,128.24 | 1 |
| IL | $1,151.49–$1,266.47 | 4 |
| IN | $1,135.20 | 1 |
| KS | $1,113.99 | 1 |
| KY | $1,111.10 | 1 |
| LA | $1,108.51–$1,166.20 | 2 |
| MA | $1,266.52–$1,408.25 | 2 |
| MD | $1,229.68–$1,402.49 | 3 |
| ME | $1,132.32–$1,199.54 | 2 |
| MI | $1,139.60–$1,203.91 | 2 |
| MN | $1,226.20 | 1 |
| MO | $1,087.25–$1,172.91 | 3 |
| MS | $1,079.87 | 1 |
| MT | $1,218.08 | 1 |
| NC | $1,145.05 | 1 |
| ND | $1,201.86 | 1 |
| NE | $1,128.47 | 1 |
| NH | $1,253.38 | 1 |
| NJ | $1,317.47–$1,386.50 | 2 |
| NM | $1,145.35 | 1 |
| NV | $1,214.50 | 1 |
| NY | $1,162.83–$1,435.72 | 5 |
| OH | $1,136.29 | 1 |
| OK | $1,111.10 | 1 |
| OR | $1,206.22–$1,319.78 | 2 |
| PA | $1,139.28–$1,266.54 | 2 |
| PR | $1,228.10 | 1 |
| RI | $1,251.00 | 1 |
| SC | $1,142.34 | 1 |
| SD | $1,199.94 | 1 |
| TN | $1,119.61 | 1 |
| TX | $1,131.29–$1,270.21 | 8 |
| UT | $1,158.74 | 1 |
| VA | $1,194.04–$1,402.49 | 2 |
| VI | $1,228.10 | 1 |
| VT | $1,195.17 | 1 |
| WA | $1,264.79–$1,439.61 | 2 |
| WI | $1,159.56 | 1 |
| WV | $1,106.37 | 1 |
| WY | $1,211.01 | 1 |
How the 47534 rate is calculated
Each of 47534’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 · 47534
RVUs × geographic indexes × conversion factor
Work7.41
7.41 RVUs× 1.000 GPCI
Practice expense28.24
28.24 RVUs× 1.000 GPCI
Malpractice0.82
0.82 RVUs× 1.000 GPCI
Adjusted RVUs
36.4700
Conversion factor
$33.4009
Medicare rate
$1,218.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 47534
The CMS indicators that decide how 47534 is paid alongside other services.
CMS payment indicators · 47534
Biliary drainage, internal-external catheter
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
47534 without 51 · national office
$1,218.13
Biliary drainage, internal-external catheter
47534-51 · Second procedure: 50%
$609.07
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%).
47534 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 47533Biliary drainageExternal catheter
- Choose 47534 when the catheter drains both internally into the bowel and externally. Choose 47533 for an external-only drainage catheter.
- 47535Biliary catheter conversionExternal to internal-external
- 47535 describes conversion of an existing external biliary drainage catheter to an internal-external catheter; 47534 reports placement of the catheter.
- 47536Biliary catheter exchangePercutaneous
- 47536 is for exchange of an existing biliary drainage catheter, not placement of a new internal-external drainage catheter.
- 47538Biliary stentInitial duct
- 47538 reports percutaneous biliary stent placement. Use 47534 when the service places an internal-external drainage catheter rather than a stent.
47534 billing questions
How does this differ from 47533?
47534 is for an internal-external catheter, which drains into the bowel and also provides external drainage. 47533 is for an external drainage catheter.
Can the cholangiogram or imaging guidance be billed separately?
Diagnostic cholangiography and imaging guidance associated with catheter placement are included in this service. Do not separately report them as though they were independent services.
Should modifier 50 be appended for bilateral drainage?
No. The biliary drainage service is not reported as a paired-side procedure, and modifier 50 is inappropriate.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple-procedure reduction.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 47534?
Document the percutaneous access, cholangiographic evaluation, catheter position, and that the catheter provides both internal and external drainage.
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
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