CPT code 47534: Biliary drainage, internal-external catheter2026 Medicare rate & RVUs in North Dakota

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.

CMS RVU26DEffective Oct 1, 2026One payment locality3.7K Medicare services in 2024

In North Dakota, Medicare pays $1,201.86 for 47534 in the office and $300.71 when it’s performed in a hospital or facility.

$1,201.86Office (non-facility)
$300.71Hospital or facility
−1.3%vs the national office rate ($1,218.13)

Check a contract rate as a % of Medicare · 47534 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 47534 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Dakota
  2. What 47534 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 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.

How North Dakota compares for 47534

Across 109 of 109 payment localities, the office rate for 47534 runs from $1,071.85 in Arkansas to $1,649.56 in San Benito County, CA. North Dakota pays $1,201.86. The RVUs are the same everywhere; the geographic indexes change the dollars.

47534 in North Dakota vs other payment areas
  1. North Dakota · this page$1,201.86
  2. Los Angeles, CA · California$1,391.69+$189.83
  3. Washington, DC area · District of Columbia$1,402.49+$200.63
  4. Miami, FL · Florida$1,298.68+$96.82
  5. Chicago, IL · Illinois$1,260.05+$58.19
  6. Manhattan, NY · New York$1,402.83+$200.97
  7. Alaska · Alaska$1,390.89+$189.03

Other areas in North Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

47534 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$1,088.34$299.83
ArkansasArkansas$1,071.85$297.76
ArizonaArizona$1,184.95$311.73
Bakersfield, CACalifornia$1,302.68$315.01
Chico, CACalifornia$1,300.18$312.51
El Centro, CACalifornia$1,300.32$312.65
Fresno, CACalifornia$1,300.18$312.51
Hanford, CACalifornia$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
47534 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,390.891
AL$1,088.341
AR$1,071.851
AZ$1,184.951
CA$1,300.18–$1,649.5629
CO$1,275.471
CT$1,301.461
DC$1,402.491
DE$1,205.281
FL$1,190.40–$1,298.683
GA$1,121.52–$1,239.472
GU$1,335.821
HI$1,335.821
IA$1,121.441
ID$1,128.241
IL$1,151.49–$1,266.474
IN$1,135.201
KS$1,113.991
KY$1,111.101
LA$1,108.51–$1,166.202
MA$1,266.52–$1,408.252
MD$1,229.68–$1,402.493
ME$1,132.32–$1,199.542
MI$1,139.60–$1,203.912
MN$1,226.201
MO$1,087.25–$1,172.913
MS$1,079.871
MT$1,218.081
NC$1,145.051
ND$1,201.861
NE$1,128.471
NH$1,253.381
NJ$1,317.47–$1,386.502
NM$1,145.351
NV$1,214.501
NY$1,162.83–$1,435.725
OH$1,136.291
OK$1,111.101
OR$1,206.22–$1,319.782
PA$1,139.28–$1,266.542
PR$1,228.101
RI$1,251.001
SC$1,142.341
SD$1,199.941
TN$1,119.611
TX$1,131.29–$1,270.218
UT$1,158.741
VA$1,194.04–$1,402.492
VI$1,228.101
VT$1,195.171
WA$1,264.79–$1,439.612
WI$1,159.561
WV$1,106.371
WY$1,211.011

See 47534 in every payment locality

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

Office or facility?

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.

The exact North Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,686

Code
47534
Physician work
7.41
Practice expense
28.24
Malpractice
0.82

GPCI2026.csv

84

Locality
North Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Office calculation for 47534 in North Dakota
ComponentRVULocality factorAdjusted
Physician work7.41× 1.0007.4100
Practice expense28.24× 1.00028.2400
Malpractice0.82× 0.4060.3329
Total RVUs35.9829
Conversion factor× 33.4009

Office rate, North Dakota$1201.86

Office: (7.41 × 1 + 28.24 × 1 + 0.82 × 0.406) × $33.4009 = $1201.86

Facility: (7.41 × 1 + 1.26 × 1 + 0.82 × 0.406) × $33.4009 = $300.71

Open 47534 in the RVU calculator

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

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

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%).

When to use modifier 51

How 47534 has changed in North Dakota

47534 · Office / nonfacility

$1201.86

Effective 2026-10-01

The base rate is $21.59 higher than on 2025-10-01, moving from $1180.27 to $1201.86 (1.8%).

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

    $1180.27changed to$1201.86

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 7.60 changed to 7.41
    • Practice expense RVU 28.48 changed to 28.24
    • Malpractice RVU 0.79 changed to 0.82
    • Malpractice GPCI 0.517 changed to 0.406

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1239.90changed to$1180.27

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 29.25 changed to 28.48
    • Malpractice RVU 0.77 changed to 0.79

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1219.66changed to$1239.90

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1295.69changed to$1219.66

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 30.28 changed to 29.25
    • Malpractice RVU 0.75 changed to 0.77
    • Malpractice GPCI 0.474 changed to 0.517
  5. January 1, 2023

    RVU23A

    $1349.06changed to$1295.69

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 31.09 changed to 30.28
    • Malpractice RVU 0.68 changed to 0.75
    • Malpractice GPCI 0.431 changed to 0.474

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1432.72changed to$1349.06

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 33.18 changed to 31.09
    • Malpractice RVU 0.65 changed to 0.68

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1456.59changed to$1432.72

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 32.45 changed to 33.18
    • Malpractice RVU 0.64 changed to 0.65
    • Malpractice GPCI 0.485 changed to 0.431

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1468.82changed to$1456.59

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 32.80 changed to 32.45
    • Malpractice RVU 0.66 changed to 0.64
    • Malpractice GPCI 0.540 changed to 0.485

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1494.57changed to$1468.82

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 33.56 changed to 32.80

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $1489.97changed to$1494.57

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 33.55 changed to 33.56
    • Malpractice RVU 0.67 changed to 0.66
    • Malpractice GPCI 0.547 changed to 0.540

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1663.14changed to$1489.97

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 8.03 changed to 7.60
    • Practice expense RVU 37.90 changed to 33.55
    • Malpractice RVU 0.94 changed to 0.67
    • Malpractice GPCI 0.554 changed to 0.547

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$1663.14

    Held through RVU16B, RVU16C, RVU16D.

  13. 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$1,201.86$300.71RVU26D
2026-07-01$1,201.86$300.71RVU26C
2026-04-01$1,201.86$300.71RVU26B
2026-01-01$1,201.86$300.71RVU26A
2025-10-01$1,180.27$337.00RVU25D
2025-07-01$1,180.27$337.00RVU25C
2025-04-01$1,180.27$337.00RVU25B
2025-01-01$1,180.27$337.00RVU25A
2024-10-01$1,239.90$343.46RVU24D
2024-07-01$1,239.90$343.46RVU24C
2024-04-01$1,239.90$343.46RVU24B
2024-03-09$1,239.90$343.46RVU24AR
2024-01-01$1,219.66$337.86RVU24A
2023-10-01$1,295.69$351.26RVU23D
2023-07-01$1,295.69$351.26RVU23C
2023-04-01$1,295.69$351.26RVU23B
2023-01-01$1,295.69$351.26RVU23A
2022-10-01$1,349.06$355.86RVU22D
2022-07-01$1,349.06$355.86RVU22C
2022-04-01$1,349.06$355.86RVU22B
2022-01-01$1,349.06$355.86RVU22A
2021-10-01$1,432.72$359.40RVU21D
2021-07-01$1,432.72$359.40RVU21C
2021-04-01$1,432.72$359.40RVU21B
2021-01-01$1,432.72$359.40RVU21A
2020-10-01$1,456.59$376.79RVU20D
2020-07-01$1,456.59$376.79RVU20C
2020-04-01$1,456.59$376.79RVU20B
2020-01-01$1,456.59$376.79RVU20A
2019-10-01$1,468.82$378.64RVU19D
2019-07-01$1,468.82$378.64RVU19C
2019-04-01$1,468.82$378.64RVU19B
2019-01-01$1,468.82$378.64RVU19A
2018-10-01$1,494.57$378.95RVU18D
2018-07-01$1,494.57$378.95RVU18C
2018-04-01$1,494.57$378.95RVU18B
2018-01-01$1,494.57$378.95RVU18AR1
2017-10-01$1,489.97$379.94RVU17D
2017-07-01$1,489.97$379.94RVU17C
2017-04-01$1,489.97$379.94RVU17B
2017-01-01$1,489.97$379.94RVU17A
2016-10-01$1,663.14$406.76RVU16D
2016-07-01$1,663.14$406.76RVU16C
2016-04-01$1,663.14$406.76RVU16B
2016-01-01$1,663.14$406.76RVU16A
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 47534 for an earlier date of service

Where the North Dakota rate applies

North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Abercrombie
  • Adams
  • Alamo
  • Alexander
  • Alice
  • Almont
  • Alsen
  • Ambrose

Browse all communities in North Dakota

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

Show the CMS file lines behind this rate
RVUs for 47534PPRRVU2026_Oct_nonQPP.csv, line 5,686 (RVU26D)
Geographic factors for North DakotaGPCI2026.csv, line 84 (RVU26D)

Open CMS sourceHow we calculate rates

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