CPT code 47538: Biliary stent, initial duct2026 Medicare rate & RVUs in Georgia
Percutaneous placement of a biliary stent in the initial duct to restore bile drainage, typically for an obstructing stricture or other blockage.
Medicare pays $3,139.31–$3,552.07 for 47538 in the office in Georgia, from Rest of Georgia to Atlanta, GA. 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.
Your location
On this page 9 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.
Where 47538 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta, GA | $3,552.07 | $206.39 |
| Rest of Georgia | $3,139.31 | $201.96 |
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.
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%).
47538 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 47533Biliary drainageExternal catheter
- Choose 47533 when the service places a biliary drainage catheter. Choose 47538 when a stent is placed in the initial duct.
- 47536Biliary catheter exchangePercutaneous
- 47536 describes exchange of an existing biliary drainage catheter; 47538 describes placement of a biliary stent in the initial duct.
- 47539Biliary stentNew percutaneous access
- 47538 is for the initial duct treated with a stent. Code 47539 addresses stent placement in an additional duct.
- 47537Biliary catheter removalPercutaneous removal
- 47537 describes removal of a biliary drainage catheter. It is not the code for placing a biliary stent.
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
Fee sheets · Coming soon
Put 47538 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist