CPT code 47541: Biliary access, into small bowel2026 Medicare rate & RVUs in Washington
Reports percutaneous creation of access through the biliary tree into the small bowel, typically to enable biliary intervention through that route.
Medicare pays $1,228.33–$1,400.66 for 47541 in the office in Washington, from Rest of Washington to King County, WA. 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.
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On this page 9 sections
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.
Where 47541 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| King County, WA | $1,400.66 | $309.70 |
| Rest of Washington | $1,228.33 | $292.07 |
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
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.
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
| 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
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%).
47541 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 47532CholangiographyExisting access
- Use 47532 for a percutaneous cholangiography injection through newly placed access. Code 47541 describes establishing access through the biliary tree into the small bowel.
- 47533Biliary drainageExternal catheter
- Use 47533 when a biliary drainage catheter is placed. Code 47541 describes access extending into the small bowel, not catheter drainage.
- 47534Biliary drainageInternal-external catheter
- Use 47534 for placement of a biliary drainage catheter; choose 47541 when the documented service is percutaneous access through the biliary tree into the small bowel.
- 47538Biliary stentInitial duct
- Use 47538 when a biliary stent is placed. Code 47541 describes access placement rather than stent treatment.
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
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