CPT code 47538: Biliary stent, initial duct2026 Medicare rate & RVUs in North Carolina
Percutaneous placement of a biliary stent in the initial duct to restore bile drainage, typically for an obstructing stricture or other blockage.
In North Carolina, Medicare pays $3,266.35 for 47538 in the office and $193.99 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 North Carolina 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. North Carolina pays $3,266.35. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$3,266.35
- Los Angeles, CA · California$4,104.04+$837.69
- Washington, DC area · District of Columbia$4,096.93+$830.58
- Miami, FL · Florida$3,656.88+$390.53
- Chicago, IL · Illinois$3,534.40+$268.05
- Manhattan, NY · New York$4,053.20+$786.85
- Alaska · Alaska$3,780.94+$514.59
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| 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 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 North Carolina 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
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.63 | × 1.000 | 4.6300 |
| Practice expense | 99.51 | × 0.933 | 92.8428 |
| Malpractice | 0.50 | × 0.639 | 0.3195 |
| Total RVUs | 97.7923 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$3266.35
Office: (4.63 × 1 + 99.51 × 0.933 + 0.5 × 0.639) × $33.4009 = $3266.35
Facility: (4.63 × 1 + 0.92 × 0.933 + 0.5 × 0.639) × $33.4009 = $193.99
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 North Carolina
47538 · Office / nonfacility
$3266.35
Effective 2026-10-01
The base rate is $86.89 higher than on 2025-10-01, moving from $3179.46 to $3266.35 (2.7%).
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
$3179.46changed to$3266.35
- 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
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$3396.57changed to$3179.46
- 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.
March 9, 2024
RVU24AR
$3341.13changed to$3396.57
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$3598.42changed to$3341.13
- 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
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$3817.75changed to$3598.42
- 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
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$4091.25changed to$3817.75
- 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
$4099.74changed to$4091.25
- 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
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$4094.92changed to$4099.74
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 116.63 changed to 116.70
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$4125.04changed to$4094.92
- 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
$4097.44changed to$4125.04
- 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 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$4276.32changed to$4097.44
- 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
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
No ratechanged to$4276.32
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 | $3,266.35 | $193.99 | RVU26D |
| 2026-07-01 | $3,266.35 | $193.99 | RVU26C |
| 2026-04-01 | $3,266.35 | $193.99 | RVU26B |
| 2026-01-01 | $3,266.35 | $193.99 | RVU26A |
| 2025-10-01 | $3,179.46 | $212.92 | RVU25D |
| 2025-07-01 | $3,179.46 | $212.92 | RVU25C |
| 2025-04-01 | $3,179.46 | $212.92 | RVU25B |
| 2025-01-01 | $3,179.46 | $212.92 | RVU25A |
| 2024-10-01 | $3,396.57 | $217.05 | RVU24D |
| 2024-07-01 | $3,396.57 | $217.05 | RVU24C |
| 2024-04-01 | $3,396.57 | $217.05 | RVU24B |
| 2024-03-09 | $3,396.57 | $217.05 | RVU24AR |
| 2024-01-01 | $3,341.13 | $213.51 | RVU24A |
| 2023-10-01 | $3,598.42 | $223.04 | RVU23D |
| 2023-07-01 | $3,598.42 | $223.04 | RVU23C |
| 2023-04-01 | $3,598.42 | $223.04 | RVU23B |
| 2023-01-01 | $3,598.42 | $223.04 | RVU23A |
| 2022-10-01 | $3,817.75 | $227.67 | RVU22D |
| 2022-07-01 | $3,817.75 | $227.67 | RVU22C |
| 2022-04-01 | $3,817.75 | $227.67 | RVU22B |
| 2022-01-01 | $3,817.75 | $227.67 | RVU22A |
| 2021-10-01 | $4,091.25 | $230.49 | RVU21D |
| 2021-07-01 | $4,091.25 | $230.49 | RVU21C |
| 2021-04-01 | $4,091.25 | $230.49 | RVU21B |
| 2021-01-01 | $4,091.25 | $230.49 | RVU21A |
| 2020-10-01 | $4,099.74 | $239.96 | RVU20D |
| 2020-07-01 | $4,099.74 | $239.96 | RVU20C |
| 2020-04-01 | $4,099.74 | $239.96 | RVU20B |
| 2020-01-01 | $4,099.74 | $239.96 | RVU20A |
| 2019-10-01 | $4,094.92 | $239.08 | RVU19D |
| 2019-07-01 | $4,094.92 | $239.08 | RVU19C |
| 2019-04-01 | $4,094.92 | $239.08 | RVU19B |
| 2019-01-01 | $4,094.92 | $239.08 | RVU19A |
| 2018-10-01 | $4,125.04 | $238.90 | RVU18D |
| 2018-07-01 | $4,125.04 | $238.90 | RVU18C |
| 2018-04-01 | $4,125.04 | $238.90 | RVU18B |
| 2018-01-01 | $4,125.04 | $238.90 | RVU18AR1 |
| 2017-10-01 | $4,097.44 | $239.31 | RVU17D |
| 2017-07-01 | $4,097.44 | $239.31 | RVU17C |
| 2017-04-01 | $4,097.44 | $239.31 | RVU17B |
| 2017-01-01 | $4,097.44 | $239.31 | RVU17A |
| 2016-10-01 | $4,276.32 | $331.17 | RVU16D |
| 2016-07-01 | $4,276.32 | $331.17 | RVU16C |
| 2016-04-01 | $4,276.32 | $331.17 | RVU16B |
| 2016-01-01 | $4,276.32 | $331.17 | 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 North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
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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