CPT code 47538: Biliary stent, initial duct2026 Medicare rate & RVUs in Montana

Percutaneous placement of a biliary stent in the initial duct to restore bile drainage, typically for an obstructing stricture or other blockage.

CMS RVU26DEffective Oct 1, 2026One payment locality685 Medicare services in 2024

In Montana, Medicare pays $3,495.04 for 47538 in the office and $202.04 when it’s performed in a hospital or facility.

$3,495.04Office (non-facility)
$202.04Hospital or facility
−0.0%vs the national office rate ($3,495.07)

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.

We’ll open 47538 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Montana
  2. What 47538 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 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 Montana 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. Montana pays $3,495.04. The RVUs are the same everywhere; the geographic indexes change the dollars.

47538 in Montana vs other payment areas
  1. Montana · this page$3,495.04
  2. Los Angeles, CA · California$4,104.04+$609.00
  3. Washington, DC area · District of Columbia$4,096.93+$601.89
  4. Miami, FL · Florida$3,656.88+$161.84
  5. Chicago, IL · Illinois$3,534.40+$39.36
  6. Manhattan, NY · New York$4,053.20+$558.16
  7. Alaska · Alaska$3,780.94+$285.90

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

Every other payment area

47538 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$3,072.36$190.99
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

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
47538 office rate range by state
State / territoryOffice rate rangeLocalities
AK$3,780.941
AL$3,072.361
AR$3,018.331
AZ$3,389.631
CA$3,809.03–$4,973.4229
CO$3,705.991
CT$3,757.601
DC$4,096.931
DE$3,454.271
FL$3,357.23–$3,656.883
GA$3,139.31–$3,552.072
GU$3,943.391
HI$3,943.391
IA$3,202.481
ID$3,220.371
IL$3,215.31–$3,598.794
IN$3,243.851
KS$3,167.711
KY$3,124.721
LA$3,112.14–$3,301.242
MA$3,670.31–$4,144.382
MD$3,535.13–$4,096.933
ME$3,222.86–$3,458.992
MI$3,208.06–$3,390.202
MN$3,579.701
MO$3,035.96–$3,335.563
MS$3,028.711
MT$3,495.041
NC$3,266.351
ND$3,485.151
NE$3,228.761
NH$3,629.261
NJ$3,808.66–$4,037.742
NM$3,222.561
NV$3,495.601
NY$3,323.92–$4,147.465
OH$3,206.041
OK$3,135.711
OR$3,476.82–$3,862.202
PA$3,221.61–$3,637.352
PR$3,531.381
RI$3,605.891
SC$3,239.961
SD$3,483.981
TN$3,184.881
TX$3,194.75–$3,686.258
UT$3,293.941
VA$3,433.66–$4,096.932
VI$3,531.381
VT$3,453.581
WA$3,669.25–$4,254.232
WI$3,343.921
WV$3,066.861
WY$3,490.731

See 47538 in every payment locality

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

Office or facility?

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 Montana 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

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Office calculation for 47538 in Montana
ComponentRVULocality factorAdjusted
Physician work4.63× 1.0004.6300
Practice expense99.51× 1.00099.5100
Malpractice0.50× 0.9980.4990
Total RVUs104.6390
Conversion factor× 33.4009

Office rate, Montana$3495.04

Office: (4.63 × 1 + 99.51 × 1 + 0.5 × 0.998) × $33.4009 = $3495.04

Facility: (4.63 × 1 + 0.92 × 1 + 0.5 × 0.998) × $33.4009 = $202.04

Open 47538 in the RVU calculator

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

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

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%).

When to use modifier 51

How 47538 has changed in Montana

47538 · Office / nonfacility

$3495.04

Effective 2026-10-01

The base rate is $69.58 higher than on 2025-10-01, moving from $3425.46 to $3495.04 (2.0%).

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

    $3425.46changed to$3495.04

    • 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
    • Malpractice GPCI 0.978 changed to 0.998

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $3659.60changed to$3425.46

    • 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.

  3. March 9, 2024

    RVU24AR

    $3599.87changed to$3659.60

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $3871.94changed to$3599.87

    • 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
  5. January 1, 2023

    RVU23A

    $4102.58changed to$3871.94

    • 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
    • Malpractice GPCI 0.977 changed to 0.978

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $4397.23changed to$4102.58

    • 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.

  7. January 1, 2021

    RVU21A

    $4402.85changed to$4397.23

    • 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
    • Malpractice GPCI 1.304 changed to 0.977

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $4399.11changed to$4402.85

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 116.63 changed to 116.70
    • Malpractice GPCI 1.631 changed to 1.304

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $4431.14changed to$4399.11

    • 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.

  10. January 1, 2018

    RVU18AR1

    $4398.17changed to$4431.14

    • 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
    • Malpractice GPCI 1.429 changed to 1.631

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $4588.72changed to$4398.17

    • 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
    • Malpractice GPCI 1.226 changed to 1.429

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$4588.72

    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$3,495.04$202.04RVU26D
2026-07-01$3,495.04$202.04RVU26C
2026-04-01$3,495.04$202.04RVU26B
2026-01-01$3,495.04$202.04RVU26A
2025-10-01$3,425.46$221.86RVU25D
2025-07-01$3,425.46$221.86RVU25C
2025-04-01$3,425.46$221.86RVU25B
2025-01-01$3,425.46$221.86RVU25A
2024-10-01$3,659.60$226.00RVU24D
2024-07-01$3,659.60$226.00RVU24C
2024-04-01$3,659.60$226.00RVU24B
2024-03-09$3,659.60$226.00RVU24AR
2024-01-01$3,599.87$222.31RVU24A
2023-10-01$3,871.94$230.76RVU23D
2023-07-01$3,871.94$230.76RVU23C
2023-04-01$3,871.94$230.76RVU23B
2023-01-01$3,871.94$230.76RVU23A
2022-10-01$4,102.58$233.95RVU22D
2022-07-01$4,102.58$233.95RVU22C
2022-04-01$4,102.58$233.95RVU22B
2022-01-01$4,102.58$233.95RVU22A
2021-10-01$4,397.23$236.93RVU21D
2021-07-01$4,397.23$236.93RVU21C
2021-04-01$4,397.23$236.93RVU21B
2021-01-01$4,397.23$236.93RVU21A
2020-10-01$4,402.85$252.54RVU20D
2020-07-01$4,402.85$252.54RVU20C
2020-04-01$4,402.85$252.54RVU20B
2020-01-01$4,402.85$252.54RVU20A
2019-10-01$4,399.11$257.50RVU19D
2019-07-01$4,399.11$257.50RVU19C
2019-04-01$4,399.11$257.50RVU19B
2019-01-01$4,399.11$257.50RVU19A
2018-10-01$4,431.14$256.99RVU18D
2018-07-01$4,431.14$256.99RVU18C
2018-04-01$4,431.14$256.99RVU18B
2018-01-01$4,431.14$256.99RVU18AR1
2017-10-01$4,398.17$254.10RVU17D
2017-07-01$4,398.17$254.10RVU17C
2017-04-01$4,398.17$254.10RVU17B
2017-01-01$4,398.17$254.10RVU17A
2016-10-01$4,588.72$346.62RVU16D
2016-07-01$4,588.72$346.62RVU16C
2016-04-01$4,588.72$346.62RVU16B
2016-01-01$4,588.72$346.62RVU16A
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 47538 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

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
RVUs for 47538PPRRVU2026_Oct_nonQPP.csv, line 5,690 (RVU26D)
Geographic factors for MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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