CPT code 47538: Biliary stent, initial duct2026 Medicare rate & RVUs in Washington, DC area
Percutaneous placement of a biliary stent in the initial duct to restore bile drainage, typically for an obstructing stricture or other blockage.
In Washington, DC area, Medicare pays $4,096.93 for 47538 in the office and $217.78 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 47538 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 47538 covers
An interventional radiologist typically places a stent through a percutaneous, often transhepatic, route to keep an obstructed bile duct open and allow bile to drain. Common clinical settings include biliary strictures and malignant obstruction. Imaging guidance and intraprocedural cholangiography, when performed, are part of the service; the code is for the initial duct treated, not a drainage catheter exchange or removal.
Report this code for stent placement in the initial duct and document the access route, treated duct, obstruction or stricture, and stent placement. Same-day preoperative and postoperative care is included in the 0-day global period. If multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is not appropriate for this service. Medicare does not pay for an assistant at surgery, co-surgeons, or team surgery for this code.
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 Washington, DC area compares for 47538
Across 109 of 109 payment localities, the office rate for 47538 runs from $3,018.33 in Arkansas to $4,973.42 in San Benito County, CA. Washington, DC area pays $4,096.93. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$4,096.93
- Los Angeles, CA · California$4,104.04+$7.11
- Miami, FL · Florida$3,656.88−$440.05
- Chicago, IL · Illinois$3,534.40−$562.53
- Manhattan, NY · New York$4,053.20−$43.73
- Alaska · Alaska$3,780.94−$315.99
- Alabama · Alabama$3,072.36−$1,024.57
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $3,018.33 | $189.64 |
| ArizonaArizona | $3,389.63 | $198.72 |
| Bakersfield, CACalifornia | $3,810.56 | $201.43 |
| Chico, CACalifornia | $3,809.03 | $199.91 |
| El Centro, CACalifornia | $3,809.11 | $199.99 |
| Fresno, CACalifornia | $3,809.03 | $199.91 |
| Hanford, CACalifornia | $3,809.03 | $199.91 |
| Madera, CACalifornia | $3,809.03 | $199.91 |
| Merced, CACalifornia | $3,809.03 | $199.91 |
| Modesto, CACalifornia | $3,809.03 | $199.91 |
| Napa, CACalifornia | $4,553.54 | $213.37 |
| Oxnard, CACalifornia | $4,098.02 | $205.70 |
| Redding, CACalifornia | $3,809.03 | $199.91 |
| Rest of CaliforniaCalifornia | $3,809.03 | $199.91 |
| Riverside, CACalifornia | $3,814.48 | $205.35 |
| Sacramento, CACalifornia | $4,034.66 | $204.90 |
| Salinas, CACalifornia | $4,020.59 | $204.01 |
| San Diego, CACalifornia | $4,143.51 | $205.09 |
| Marin County, CACalifornia | $4,863.45 | $220.33 |
| San Francisco, CACalifornia | $4,862.89 | $219.76 |
| San Benito County, CACalifornia | $4,973.42 | $224.92 |
| Santa Clara County, CACalifornia | $4,971.10 | $222.60 |
| San Luis Obispo, CACalifornia | $3,951.95 | $201.23 |
| Santa Cruz, CACalifornia | $4,205.17 | $204.18 |
| Santa Maria, CACalifornia | $4,043.39 | $203.76 |
| Santa Rosa, CACalifornia | $4,249.77 | $205.97 |
| Stockton, CACalifornia | $3,809.03 | $199.91 |
| Vallejo, CACalifornia | $4,552.72 | $212.55 |
| Visalia, CACalifornia | $3,809.03 | $199.91 |
| Yuba City, CACalifornia | $3,809.03 | $199.91 |
| ColoradoColorado | $3,705.99 | $202.24 |
| ConnecticutConnecticut | $3,757.60 | $211.04 |
| DelawareDelaware | $3,454.27 | $200.79 |
| Fort Lauderdale, FLFlorida | $3,551.77 | $215.97 |
| Rest of FloridaFlorida | $3,357.23 | $209.12 |
| Atlanta, GAGeorgia | $3,552.07 | $206.39 |
| Rest of GeorgiaGeorgia | $3,139.31 | $201.96 |
| Hawaii, Guam, HIHawaii | $3,943.39 | $199.25 |
| IowaIowa | $3,202.48 | $189.39 |
| IdahoIdaho | $3,220.37 | $190.82 |
| East St. Louis, ILIllinois | $3,246.11 | $216.55 |
| Rest of IllinoisIllinois | $3,215.31 | $208.80 |
| Suburban Chicago, ILIllinois | $3,598.79 | $216.88 |
| IndianaIndiana | $3,243.85 | $191.25 |
| KansasKansas | $3,167.71 | $190.84 |
| KentuckyKentucky | $3,124.72 | $197.25 |
| New Orleans, LALouisiana | $3,301.24 | $202.53 |
| Rest of LouisianaLouisiana | $3,112.14 | $197.84 |
| Metropolitan Boston, MAMassachusetts | $4,144.38 | $212.54 |
| Rest of MassachusettsMassachusetts | $3,670.31 | $202.79 |
| Baltimore area, MDMaryland | $3,744.13 | $210.75 |
| Rest of MarylandMaryland | $3,535.13 | $202.62 |
| Rest of MaineMaine | $3,222.86 | $193.30 |
| Southern Maine, MEMaine | $3,458.99 | $195.64 |
| Detroit, MIMichigan | $3,390.20 | $212.46 |
| Rest of MichiganMichigan | $3,208.06 | $201.56 |
| MinnesotaMinnesota | $3,579.70 | $191.21 |
| Metropolitan Kansas City, MOMissouri | $3,291.94 | $199.82 |
| Metropolitan St. Louis, MOMissouri | $3,335.56 | $200.63 |
| Rest of MissouriMissouri | $3,035.96 | $197.40 |
| MississippiMississippi | $3,028.71 | $193.45 |
| MontanaMontana | $3,495.04 | $202.04 |
| North CarolinaNorth Carolina | $3,266.35 | $193.99 |
| North DakotaNorth Dakota | $3,485.15 | $192.16 |
| NebraskaNebraska | $3,228.76 | $189.32 |
| New HampshireNew Hampshire | $3,629.26 | $201.25 |
| Northern New JerseyNew Jersey | $4,037.74 | $217.87 |
| Rest of New JerseyNew Jersey | $3,808.66 | $212.71 |
| New MexicoNew Mexico | $3,222.56 | $202.88 |
| NevadaNevada | $3,495.60 | $199.32 |
| NYC suburbs and Long Island, NYNew York | $4,147.46 | $232.09 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $3,821.29 | $215.46 |
| Queens, NYNew York | $4,117.27 | $224.95 |
| Rest of New YorkNew York | $3,323.92 | $195.58 |
| OhioOhio | $3,206.04 | $199.54 |
| OklahomaOklahoma | $3,135.71 | $195.06 |
| Portland, OROregon | $3,862.20 | $203.69 |
| Rest of OregonOregon | $3,476.82 | $196.99 |
| Metropolitan Philadelphia, PAPennsylvania | $3,637.35 | $209.34 |
| Rest of PennsylvaniaPennsylvania | $3,221.61 | $198.64 |
| Puerto RicoPuerto Rico | $3,531.38 | $202.16 |
| Rhode IslandRhode Island | $3,605.89 | $204.22 |
| South CarolinaSouth Carolina | $3,239.96 | $197.23 |
| South DakotaSouth Dakota | $3,483.98 | $190.99 |
| TennesseeTennessee | $3,184.88 | $191.55 |
| Austin, TXTexas | $3,686.25 | $202.26 |
| Beaumont, TXTexas | $3,194.75 | $198.12 |
| Brazoria, TXTexas | $3,462.72 | $199.36 |
| Dallas, TXTexas | $3,480.80 | $200.97 |
| Fort Worth, TXTexas | $3,447.78 | $200.88 |
| Galveston, TXTexas | $3,470.17 | $200.23 |
| Houston, TXTexas | $3,479.32 | $209.38 |
| Rest of TexasTexas | $3,323.94 | $198.89 |
| UtahUtah | $3,293.94 | $198.53 |
| VirginiaVirginia | $3,433.66 | $196.64 |
| Virgin Islands, VIUnited States Virgin Islands | $3,531.38 | $202.16 |
| VermontVermont | $3,453.58 | $193.52 |
| Rest of WashingtonWashington | $3,669.25 | $201.72 |
| King County, WAWashington | $4,254.23 | $213.73 |
| WisconsinWisconsin | $3,343.92 | $189.23 |
| West VirginiaWest Virginia | $3,066.86 | $205.25 |
| WyomingWyoming | $3,490.73 | $197.73 |
47538 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.
$3,018.33
$4,391.23
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 | $3,780.94 | 1 |
| AL | $3,072.36 | 1 |
| AR | $3,018.33 | 1 |
| AZ | $3,389.63 | 1 |
| CA | $3,809.03–$4,973.42 | 29 |
| CO | $3,705.99 | 1 |
| CT | $3,757.60 | 1 |
| DC | $4,096.93 | 1 |
| DE | $3,454.27 | 1 |
| FL | $3,357.23–$3,656.88 | 3 |
| GA | $3,139.31–$3,552.07 | 2 |
| GU | $3,943.39 | 1 |
| HI | $3,943.39 | 1 |
| IA | $3,202.48 | 1 |
| ID | $3,220.37 | 1 |
| IL | $3,215.31–$3,598.79 | 4 |
| IN | $3,243.85 | 1 |
| KS | $3,167.71 | 1 |
| KY | $3,124.72 | 1 |
| LA | $3,112.14–$3,301.24 | 2 |
| MA | $3,670.31–$4,144.38 | 2 |
| MD | $3,535.13–$4,096.93 | 3 |
| ME | $3,222.86–$3,458.99 | 2 |
| MI | $3,208.06–$3,390.20 | 2 |
| MN | $3,579.70 | 1 |
| MO | $3,035.96–$3,335.56 | 3 |
| MS | $3,028.71 | 1 |
| MT | $3,495.04 | 1 |
| NC | $3,266.35 | 1 |
| ND | $3,485.15 | 1 |
| NE | $3,228.76 | 1 |
| NH | $3,629.26 | 1 |
| NJ | $3,808.66–$4,037.74 | 2 |
| NM | $3,222.56 | 1 |
| NV | $3,495.60 | 1 |
| NY | $3,323.92–$4,147.46 | 5 |
| OH | $3,206.04 | 1 |
| OK | $3,135.71 | 1 |
| OR | $3,476.82–$3,862.20 | 2 |
| PA | $3,221.61–$3,637.35 | 2 |
| PR | $3,531.38 | 1 |
| RI | $3,605.89 | 1 |
| SC | $3,239.96 | 1 |
| SD | $3,483.98 | 1 |
| TN | $3,184.88 | 1 |
| TX | $3,194.75–$3,686.25 | 8 |
| UT | $3,293.94 | 1 |
| VA | $3,433.66–$4,096.93 | 2 |
| VI | $3,531.38 | 1 |
| VT | $3,453.58 | 1 |
| WA | $3,669.25–$4,254.23 | 2 |
| WI | $3,343.92 | 1 |
| WV | $3,066.86 | 1 |
| WY | $3,490.73 | 1 |
How the 47538 rate is calculated
Each of 47538’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 · 47538
RVUs × geographic indexes × conversion factor
Work4.63
4.63 RVUs× 1.000 GPCI
Practice expense99.51
99.51 RVUs× 1.000 GPCI
Malpractice0.50
0.50 RVUs× 1.000 GPCI
Adjusted RVUs
104.6400
Conversion factor
$33.4009
Medicare rate
$3,495.07
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Washington, DC area inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,690
- Code
- 47538
- Physician work
- 4.63
- Practice expense
- 99.51
- Malpractice
- 0.50
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.63 | × 1.054 | 4.8800 |
| Practice expense | 99.51 | × 1.178 | 117.2228 |
| Malpractice | 0.50 | × 1.113 | 0.5565 |
| Total RVUs | 122.6593 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$4096.93
Office: (4.63 × 1.054 + 99.51 × 1.178 + 0.5 × 1.113) × $33.4009 = $4096.93
Facility: (4.63 × 1.054 + 0.92 × 1.178 + 0.5 × 1.113) × $33.4009 = $217.78
Payment rules and modifiers for 47538
The CMS indicators that decide how 47538 is paid alongside other services.
CMS payment indicators · 47538
Biliary stent, initial duct
| 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
47538 without 51 · national office
$3,495.07
Biliary stent, initial duct
47538-51 · Second procedure: 50%
$1,747.54
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%).
How 47538 has changed in Washington, DC area
47538 · Office / nonfacility
$4096.93
Effective 2026-10-01
The base rate is $34.49 higher than on 2025-10-01, moving from $4062.44 to $4096.93 (0.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$4062.44changed to$4096.93
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 4.75 changed to 4.63
- Practice expense RVU 100.66 changed to 99.51
- Work GPCI 1.057 changed to 1.054
- Practice expense GPCI 1.192 changed to 1.178
- Malpractice GPCI 1.168 changed to 1.113
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$4340.94changed to$4062.44
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 104.71 changed to 100.66
- Malpractice RVU 0.49 changed to 0.50
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$4270.09changed to$4340.94
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$4675.80changed to$4270.09
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 109.05 changed to 104.71
- Malpractice RVU 0.47 changed to 0.49
- Work GPCI 1.056 changed to 1.057
- Practice expense GPCI 1.214 changed to 1.192
- Malpractice GPCI 1.231 changed to 1.168
January 1, 2023
RVU23A
$5042.12changed to$4675.80
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 113.39 changed to 109.05
- Malpractice RVU 0.42 changed to 0.47
- Work GPCI 1.054 changed to 1.056
- Practice expense GPCI 1.236 changed to 1.214
- Malpractice GPCI 1.294 changed to 1.231
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$5406.11changed to$5042.12
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 120.85 changed to 113.39
- Malpractice RVU 0.43 changed to 0.42
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$5341.61changed to$5406.11
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 116.70 changed to 120.85
- Malpractice RVU 0.42 changed to 0.43
- Work GPCI 1.049 changed to 1.054
- Practice expense GPCI 1.221 changed to 1.236
- Malpractice GPCI 1.277 changed to 1.294
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$5262.88changed to$5341.61
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 116.63 changed to 116.70
- Work GPCI 1.045 changed to 1.049
- Practice expense GPCI 1.205 changed to 1.221
- Malpractice GPCI 1.261 changed to 1.277
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$5301.77changed to$5262.88
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 117.67 changed to 116.63
- Malpractice RVU 0.41 changed to 0.42
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$5266.23changed to$5301.77
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 117.20 changed to 117.67
- Malpractice RVU 0.42 changed to 0.41
- Work GPCI 1.048 changed to 1.045
- Malpractice GPCI 1.271 changed to 1.261
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$5488.92changed to$5266.23
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 6.60 changed to 4.75
- Practice expense RVU 120.85 changed to 117.20
- Malpractice RVU 0.58 changed to 0.42
- Work GPCI 1.051 changed to 1.048
- Malpractice GPCI 1.280 changed to 1.271
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
No ratechanged to$5488.92
Held through RVU16B, RVU16C, RVU16D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $4,096.93 | $217.78 | RVU26D |
| 2026-07-01 | $4,096.93 | $217.78 | RVU26C |
| 2026-04-01 | $4,096.93 | $217.78 | RVU26B |
| 2026-01-01 | $4,096.93 | $217.78 | RVU26A |
| 2025-10-01 | $4,062.44 | $243.76 | RVU25D |
| 2025-07-01 | $4,062.44 | $243.76 | RVU25C |
| 2025-04-01 | $4,062.44 | $243.76 | RVU25B |
| 2025-01-01 | $4,062.44 | $243.76 | RVU25A |
| 2024-10-01 | $4,340.94 | $248.08 | RVU24D |
| 2024-07-01 | $4,340.94 | $248.08 | RVU24C |
| 2024-04-01 | $4,340.94 | $248.08 | RVU24B |
| 2024-03-09 | $4,340.94 | $248.08 | RVU24AR |
| 2024-01-01 | $4,270.09 | $244.03 | RVU24A |
| 2023-10-01 | $4,675.80 | $255.41 | RVU23D |
| 2023-07-01 | $4,675.80 | $255.41 | RVU23C |
| 2023-04-01 | $4,675.80 | $255.41 | RVU23B |
| 2023-01-01 | $4,675.80 | $255.41 | RVU23A |
| 2022-10-01 | $5,042.12 | $260.50 | RVU22D |
| 2022-07-01 | $5,042.12 | $260.50 | RVU22C |
| 2022-04-01 | $5,042.12 | $260.50 | RVU22B |
| 2022-01-01 | $5,042.12 | $260.50 | RVU22A |
| 2021-10-01 | $5,406.11 | $263.97 | RVU21D |
| 2021-07-01 | $5,406.11 | $263.97 | RVU21C |
| 2021-04-01 | $5,406.11 | $263.97 | RVU21B |
| 2021-01-01 | $5,406.11 | $263.97 | RVU21A |
| 2020-10-01 | $5,341.61 | $274.09 | RVU20D |
| 2020-07-01 | $5,341.61 | $274.09 | RVU20C |
| 2020-04-01 | $5,341.61 | $274.09 | RVU20B |
| 2020-01-01 | $5,341.61 | $274.09 | RVU20A |
| 2019-10-01 | $5,262.88 | $272.24 | RVU19D |
| 2019-07-01 | $5,262.88 | $272.24 | RVU19C |
| 2019-04-01 | $5,262.88 | $272.24 | RVU19B |
| 2019-01-01 | $5,262.88 | $272.24 | RVU19A |
| 2018-10-01 | $5,301.77 | $271.92 | RVU18D |
| 2018-07-01 | $5,301.77 | $271.92 | RVU18C |
| 2018-04-01 | $5,301.77 | $271.92 | RVU18B |
| 2018-01-01 | $5,301.77 | $271.92 | RVU18AR1 |
| 2017-10-01 | $5,266.23 | $272.63 | RVU17D |
| 2017-07-01 | $5,266.23 | $272.63 | RVU17C |
| 2017-04-01 | $5,266.23 | $272.63 | RVU17B |
| 2017-01-01 | $5,266.23 | $272.63 | RVU17A |
| 2016-10-01 | $5,488.92 | $377.19 | RVU16D |
| 2016-07-01 | $5,488.92 | $377.19 | RVU16C |
| 2016-04-01 | $5,488.92 | $377.19 | RVU16B |
| 2016-01-01 | $5,488.92 | $377.19 | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
47538 billing questions
How does this differ from a biliary drainage catheter placement?
This code is for placing a stent to maintain duct patency. Codes 47533 and 47534 describe placement of biliary drainage catheters, rather than the stent service.
Can the cholangiography or imaging guidance be billed separately?
Imaging guidance and intraprocedural cholangiography, when performed as part of the stent placement, are included in this service.
What supports reporting this code?
Document the percutaneous access, the duct treated, the clinical obstruction or stricture, and placement of the stent in the initial duct.
Should modifier 50 be appended for bilateral duct treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the applicable duct-level service rather than using modifier 50.
How are other procedures in the same session paid?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay for an assistant at surgery for this code, and 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
Show the CMS file lines behind this rate
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Put 47538 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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