CPT code 47535: Biliary catheter conversion, external to internal-external2026 Medicare rate & RVUs in Texas
Reports percutaneous conversion of an existing external biliary drainage catheter to an internal-external catheter, including cholangiography and imaging guidance.
Medicare pays $783.87–$887.92 for 47535 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
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 9 sections
What 47535 covers
An interventional radiologist converts an existing external biliary drainage catheter by directing the catheter across the biliary obstruction and into the bowel, creating internal-external drainage. The service is typically performed in a hospital imaging suite for a patient whose biliary obstruction was initially managed with external drainage and can now be traversed. Diagnostic cholangiography, imaging guidance, and the associated radiological supervision and interpretation are included in the conversion service.
Report this code when the existing external catheter is converted, rather than when a catheter is newly placed or an existing catheter is simply exchanged. The procedure note should identify the prior external catheter, document the conversion and final catheter position, and support the cholangiographic and imaging work. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, 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 47535 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$783.87 to $887.92
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $887.92 | $169.49 |
| Beaumont, TX | $783.87 | $165.95 |
| Brazoria, TX | $839.90 | $166.97 |
| Dallas, TX | $844.68 | $168.35 |
| Fort Worth, TX | $837.81 | $168.28 |
| Galveston, TX | $842.00 | $167.72 |
| Houston, TX | $849.87 | $175.59 |
| Rest of Texas | $811.01 | $166.60 |
How the 47535 rate is calculated
Each of 47535’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 · 47535
RVUs × geographic indexes × conversion factor
Work3.85
3.85 RVUs× 1.000 GPCI
Practice expense21.12
21.12 RVUs× 1.000 GPCI
Malpractice0.43
0.43 RVUs× 1.000 GPCI
Adjusted RVUs
25.4000
Conversion factor
$33.4009
Medicare rate
$848.38
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 47535
The CMS indicators that decide how 47535 is paid alongside other services.
CMS payment indicators · 47535
Biliary catheter conversion, external to internal-external
| 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
47535 without 51 · national office
$848.38
Biliary catheter conversion, external to internal-external
47535-51 · Second procedure: 50%
$424.19
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%).
47535 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 47534Biliary drainageInternal-external catheter
- Use 47534 for initial placement of an internal-external biliary drainage catheter. Use 47535 when an existing external catheter is converted to internal-external drainage.
- 47536Biliary catheter exchangePercutaneous
- Use 47536 for exchange of an existing biliary drainage catheter. Use 47535 when the procedure converts an existing external catheter to internal-external drainage.
- 47533Biliary drainageExternal catheter
- Use 47533 for initial placement of an external biliary drainage catheter. It does not describe conversion of an existing external catheter to internal-external drainage.
47535 billing questions
How is conversion different from initial internal-external catheter placement?
Use 47535 when an existing external biliary drainage catheter is converted to internal-external drainage. Initial placement of an internal-external catheter is reported with 47534.
How is conversion different from catheter exchange?
Code 47535 describes changing an existing external catheter into an internal-external drainage catheter. Code 47536 describes exchange of an existing biliary drainage catheter, not this conversion.
Can cholangiography or imaging guidance be billed separately?
Diagnostic cholangiography, imaging guidance, and associated radiological supervision and interpretation are included in 47535.
Should modifier 50 be appended?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
What documentation supports reporting 47535?
Document the existing external catheter, the percutaneous conversion, cholangiographic findings, and the final internal-external catheter position.
How are other same-session procedures handled?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
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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