CPT code 47536: Biliary catheter exchange, percutaneous2026 Medicare rate & RVUs in California
Report this service when a clinician exchanges an existing percutaneous biliary drainage catheter, using the established access route to place its replacement.
Medicare pays $650.65–$835.13 for 47536 in the office in California, from Chico, CA to San Benito County, CA. 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 47536 covers
An interventional radiologist or other qualified physician exchanges a biliary drainage catheter through an existing percutaneous access route, typically under imaging guidance. The service is used when a catheter needs replacement while biliary drainage access remains necessary, such as during a scheduled catheter change or when the existing catheter is obstructed or no longer functioning as intended. Fluoroscopic guidance is included when performed.
Choose this code for an exchange, not for creating new drainage access, changing an external catheter to an internal-external configuration, or simply removing a catheter. The report should identify the existing catheter and access, explain the exchange, and document the replacement catheter’s position and outcome. The code 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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 47536 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$650.65 to $835.13
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $651.51 | $114.48 |
| Chico, CA | $650.65 | $113.62 |
| El Centro, CA | $650.70 | $113.67 |
| Fresno, CA | $650.65 | $113.62 |
| Hanford, CA | $650.65 | $113.62 |
| Los Angeles, CA | $698.29 | $118.63 |
| Madera, CA | $650.65 | $113.62 |
| Marin County, CA | $816.81 | $125.92 |
| Merced, CA | $650.65 | $113.62 |
| Modesto, CA | $650.65 | $113.62 |
| Napa, CA | $767.60 | $121.79 |
| Oxnard, CA | $696.29 | $117.12 |
| Redding, CA | $650.65 | $113.62 |
| Rest of California | $650.65 | $113.62 |
| Riverside, CA | $653.70 | $116.67 |
| Sacramento, CA | $686.46 | $116.60 |
| Salinas, CA | $683.99 | $116.10 |
| San Benito County, CA | $835.13 | $128.56 |
| San Diego, CA | $702.85 | $116.82 |
| San Francisco, CA | $816.49 | $125.60 |
| San Luis Obispo, CA | $672.60 | $114.50 |
| Santa Clara County, CA | $833.83 | $127.26 |
| Santa Cruz, CA | $711.73 | $116.39 |
| Santa Maria, CA | $687.31 | $115.98 |
| Santa Rosa, CA | $719.13 | $117.42 |
| Stockton, CA | $650.65 | $113.62 |
| Vallejo, CA | $767.14 | $121.33 |
| Visalia, CA | $650.65 | $113.62 |
| Yuba City, CA | $650.65 | $113.62 |
How the 47536 rate is calculated
Each of 47536’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 · 47536
RVUs × geographic indexes × conversion factor
Work2.54
2.54 RVUs× 1.000 GPCI
Practice expense15.28
15.28 RVUs× 1.000 GPCI
Malpractice0.28
0.28 RVUs× 1.000 GPCI
Adjusted RVUs
18.1000
Conversion factor
$33.4009
Medicare rate
$604.56
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 47536
The CMS indicators that decide how 47536 is paid alongside other services.
CMS payment indicators · 47536
Biliary catheter exchange, percutaneous
| 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
47536 without 51 · national office
$604.56
Biliary catheter exchange, percutaneous
47536-51 · Second procedure: 50%
$302.28
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%).
47536 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 47533Biliary drainageExternal catheter
- Choose 47533 for placement of a percutaneous external biliary drainage catheter. Choose 47536 when an existing catheter is exchanged.
- 47534Biliary drainageInternal-external catheter
- Code 47534 describes placement of an internal-external drainage catheter. Code 47536 describes exchanging an existing biliary drainage catheter.
- 47535Biliary catheter conversionExternal to internal-external
- Code 47535 applies when the catheter is converted from external to internal-external drainage. A replacement without that configuration change is an exchange.
- 47537Biliary catheter removalPercutaneous removal
- Code 47537 is for catheter removal without replacement; 47536 is for exchange with a replacement catheter.
47536 billing questions
How is an exchange different from a new catheter placement?
Report 47536 when an existing percutaneous biliary drainage catheter is exchanged through its established access route. Codes 47533 and 47534 describe placement of a drainage catheter rather than exchange.
When should 47535 be considered instead?
Use 47535 for conversion of an external biliary drainage catheter to an internal-external catheter configuration. An exchange that replaces the catheter without that conversion is reported with 47536.
Is catheter removal reported as an exchange?
No. Code 47537 describes percutaneous removal of a biliary drainage catheter; 47536 describes exchange with a replacement catheter.
Is fluoroscopic guidance included?
Fluoroscopic guidance is included when performed. Document the exchange and the replacement catheter’s final position and outcome.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction.
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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