CPT code 47541: Biliary access, into small bowel2026 Medicare rate & RVUs in Iowa

Reports percutaneous creation of access through the biliary tree into the small bowel, typically to enable biliary intervention through that route.

CMS RVU26DEffective Oct 1, 2026One payment locality137 Medicare services in 2024

In Iowa, Medicare pays $1,086.17 for 47541 in the office and $272.61 when it’s performed in a hospital or facility.

$1,086.17Office (non-facility)
$272.61Hospital or facility
−8.2%vs the national office rate ($1,182.73)

Check a contract rate as a % of Medicare · 47541 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 47541 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 47541 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 47541 covers

An interventional radiologist or other qualified physician creates a percutaneous route through the biliary tree and across into the small bowel. The service is used when access across the biliary pathway is needed for an intervention, rather than placement of a biliary drainage catheter or stent. Imaging guidance and associated radiological supervision and interpretation are included, as is diagnostic cholangiography when performed.

Report the code when documentation supports percutaneous access traversing the biliary tree into the small bowel. Record the route, access achieved, imaging guidance, and any cholangiography performed. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment is inappropriate for this anatomy and service. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted 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 Iowa compares for 47541

Across 109 of 109 payment localities, the office rate for 47541 runs from $1,037.18 in Arkansas to $1,606.80 in San Benito County, CA. Iowa pays $1,086.17. The RVUs are the same everywhere; the geographic indexes change the dollars.

47541 in Iowa vs other payment areas
  1. Iowa · this page$1,086.17
  2. Los Angeles, CA · California$1,353.22+$267.05
  3. Washington, DC area · District of Columbia$1,364.15+$277.98
  4. Miami, FL · Florida$1,264.45+$178.28
  5. Chicago, IL · Illinois$1,225.70+$139.53
  6. Manhattan, NY · New York$1,364.83+$278.66
  7. Alaska · Alaska$1,340.61+$254.44

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

Every other payment area

47541 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$1,053.58$275.59
ArkansasArkansas$1,037.18$273.42
ArizonaArizona$1,149.67$288.10
Bakersfield, CACalifornia$1,265.52$291.03
Chico, CACalifornia$1,263.01$288.52
El Centro, CACalifornia$1,263.15$288.66
Fresno, CACalifornia$1,263.01$288.52
Hanford, CACalifornia$1,263.01$288.52

47541 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$1,037.18

$1,434.91

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
47541 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,340.611
AL$1,053.581
AR$1,037.181
AZ$1,149.671
CA$1,263.01–$1,606.8029
CO$1,238.961
CT$1,265.041
DC$1,364.151
DE$1,169.741
FL$1,155.89–$1,264.453
GA$1,087.24–$1,204.042
GU$1,298.811
HI$1,298.811
IA$1,086.171
ID$1,093.001
IL$1,117.40–$1,231.424
IN$1,099.911
KS$1,078.931
KY$1,076.581
LA$1,074.06–$1,131.452
MA$1,230.01–$1,369.922
MD$1,193.81–$1,364.153
ME$1,097.23–$1,163.842
MI$1,105.08–$1,169.492
MN$1,189.841
MO$1,053.02–$1,137.923
MS$1,045.411
MT$1,182.671
NC$1,109.861
ND$1,165.861
NE$1,093.111
NH$1,217.491
NJ$1,280.25–$1,348.032
NM$1,110.861
NV$1,178.921
NY$1,127.57–$1,397.755
OH$1,101.651
OK$1,076.401
OR$1,170.56–$1,282.712
PA$1,104.53–$1,230.482
PR$1,192.581
RI$1,214.681
SC$1,107.441
SD$1,163.871
TN$1,084.541
TX$1,096.60–$1,234.138
UT$1,123.761
VA$1,158.49–$1,364.152
VI$1,192.581
VT$1,159.361
WA$1,228.33–$1,400.662
WI$1,123.831
WV$1,072.541
WY$1,175.341

See 47541 in every payment locality

How the 47541 rate is calculated

Each of 47541’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 · 47541

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.58

6.58 RVUs× 1.000 GPCI

Practice expense27.98

27.98 RVUs× 1.000 GPCI

Malpractice0.85

0.85 RVUs× 1.000 GPCI

Adjusted RVUs

35.4100

Conversion factor

$33.4009

Medicare rate

$1,182.73

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,693

Code
47541
Physician work
6.58
Practice expense
27.98
Malpractice
0.85

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 47541 in Iowa
ComponentRVULocality factorAdjusted
Physician work6.58× 1.0006.5800
Practice expense27.98× 0.91525.6017
Malpractice0.85× 0.3970.3375
Total RVUs32.5191
Conversion factor× 33.4009

Office rate, Iowa$1086.17

Office: (6.58 × 1 + 27.98 × 0.915 + 0.85 × 0.397) × $33.4009 = $1086.17

Facility: (6.58 × 1 + 1.36 × 0.915 + 0.85 × 0.397) × $33.4009 = $272.61

Open 47541 in the RVU calculator

Payment rules and modifiers for 47541

The CMS indicators that decide how 47541 is paid alongside other services.

CMS payment indicators · 47541

Biliary access, into small bowel

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

47541 without 51 · national office

$1,182.73

Biliary access, into small bowel

47541-51 · Second procedure: 50%

$591.37

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 47541 has changed in Iowa

47541 · Office / nonfacility

$1086.17

Effective 2026-10-01

The base rate is $80.78 higher than on 2025-10-01, moving from $1005.39 to $1086.17 (8.0%).

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

    $1005.39changed to$1086.17

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.75 changed to 6.58
    • Practice expense RVU 26.28 changed to 27.98
    • Malpractice RVU 0.74 changed to 0.85
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1050.44changed to$1005.39

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 26.81 changed to 26.28
    • Malpractice RVU 0.72 changed to 0.74

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1033.29changed to$1050.44

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1091.23changed to$1033.29

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 27.62 changed to 26.81
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457
  5. January 1, 2023

    RVU23A

    $1133.00changed to$1091.23

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 28.35 changed to 27.62
    • Malpractice RVU 0.65 changed to 0.72
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1169.14changed to$1133.00

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 29.20 changed to 28.35
    • Malpractice RVU 0.64 changed to 0.65

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1145.42changed to$1169.14

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 27.27 changed to 29.20
    • Malpractice RVU 0.60 changed to 0.64
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1117.15changed to$1145.42

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 26.45 changed to 27.27
    • Malpractice RVU 0.61 changed to 0.60
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1101.40changed to$1117.15

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 26.01 changed to 26.45
    • Malpractice RVU 0.60 changed to 0.61

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $1091.52changed to$1101.40

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 25.91 changed to 26.01
    • Malpractice RVU 0.64 changed to 0.60
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1089.79changed to$1091.52

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 5.61 changed to 6.75
    • Practice expense RVU 27.39 changed to 25.91
    • Malpractice RVU 0.58 changed to 0.64
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$1089.79

    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$1,086.17$272.61RVU26D
2026-07-01$1,086.17$272.61RVU26C
2026-04-01$1,086.17$272.61RVU26B
2026-01-01$1,086.17$272.61RVU26A
2025-10-01$1,005.39$298.09RVU25D
2025-07-01$1,005.39$298.09RVU25C
2025-04-01$1,005.39$298.09RVU25B
2025-01-01$1,005.39$298.09RVU25A
2024-10-01$1,050.44$304.63RVU24D
2024-07-01$1,050.44$304.63RVU24C
2024-04-01$1,050.44$304.63RVU24B
2024-03-09$1,050.44$304.63RVU24AR
2024-01-01$1,033.29$299.66RVU24A
2023-10-01$1,091.23$311.04RVU23D
2023-07-01$1,091.23$311.04RVU23C
2023-04-01$1,091.23$311.04RVU23B
2023-01-01$1,091.23$311.04RVU23A
2022-10-01$1,133.00$314.09RVU22D
2022-07-01$1,133.00$314.09RVU22C
2022-04-01$1,133.00$314.09RVU22B
2022-01-01$1,133.00$314.09RVU22A
2021-10-01$1,169.14$315.28RVU21D
2021-07-01$1,169.14$315.28RVU21C
2021-04-01$1,169.14$315.28RVU21B
2021-01-01$1,169.14$315.28RVU21A
2020-10-01$1,145.42$327.75RVU20D
2020-07-01$1,145.42$327.75RVU20C
2020-04-01$1,145.42$327.75RVU20B
2020-01-01$1,145.42$327.75RVU20A
2019-10-01$1,117.15$327.09RVU19D
2019-07-01$1,117.15$327.09RVU19C
2019-04-01$1,117.15$327.09RVU19B
2019-01-01$1,117.15$327.09RVU19A
2018-10-01$1,101.40$328.54RVU18D
2018-07-01$1,101.40$328.54RVU18C
2018-04-01$1,101.40$328.54RVU18B
2018-01-01$1,101.40$328.54RVU18AR1
2017-10-01$1,091.52$329.17RVU17D
2017-07-01$1,091.52$329.17RVU17C
2017-04-01$1,091.52$329.17RVU17B
2017-01-01$1,091.52$329.17RVU17A
2016-10-01$1,089.79$275.90RVU16D
2016-07-01$1,089.79$275.90RVU16C
2016-04-01$1,089.79$275.90RVU16B
2016-01-01$1,089.79$275.90RVU16A
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 47541 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

47541 billing questions

How does this differ from biliary drainage catheter placement?

This code describes establishing percutaneous access through the biliary tree into the small bowel. Codes 47533 and 47534 describe placement of a biliary drainage catheter.

Is diagnostic cholangiography reported separately?

Diagnostic cholangiography performed as part of this access service is included. The documentation should identify whether it was performed and support the access route.

Can modifier 50 be used?

No bilateral adjustment applies; the anatomy and service make modifier 50 inappropriate.

Does Medicare allow an assistant or co-surgeon?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

What same-session payment reduction should billers expect?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures performed in the same session are paid at 50%.

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 47541PPRRVU2026_Oct_nonQPP.csv, line 5,693 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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