CPT code 47542: Biliary dilation, bile duct or ampulla2026 Medicare rate & RVUs in Marin County, CA

Percutaneous balloon dilation opens a narrowed bile duct or ampulla during a biliary intervention and is reported only with a qualifying primary procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality1K Medicare services in 2024

In Marin County, CA, Medicare pays $631.38 for 47542 in the office and $125.57 when it’s performed in a hospital or facility.

$631.38Office (non-facility)
$125.57Hospital or facility
+32.7%vs the national office rate ($475.96)

Check a contract rate as a % of Medicare · 47542 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 47542 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Marin County, CA
  2. What 47542 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 47542 covers

An interventional radiologist uses percutaneous access and imaging guidance to position and inflate a balloon in a narrowed bile duct or at the ampulla. The goal is to widen a stricture that impedes bile flow, such as a narrowing within the biliary tree or at its outlet into the small bowel. The service may occur during an image-guided biliary intervention in a hospital or other procedural setting.

Report 47542 as an add-on with a primary procedure, not by itself. Documentation should identify the treated duct or ampulla, the narrowing and its clinical significance, and the balloon dilation performed. The record should also support that the dilation is distinct from work already included in the primary service; for example, stent-placement codes include pre- and post-dilation when performed. CMS treats this add-on as paid within the primary procedure’s global period, so it has no separate payment outside that primary procedure.

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 Marin County, CA compares for 47542

Across 109 of 109 payment localities, the office rate for 47542 runs from $418.15 in Arkansas to $645.52 in San Benito County, CA. Marin County, CA pays $631.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

47542 in Marin County, CA vs other payment areas
  1. Marin County, CA · this page$631.38
  2. Bakersfield, CA · California$509.14−$122.24
  3. Chico, CA · California$508.15−$123.23
  4. El Centro, CA · California$508.20−$123.18
  5. Fresno, CA · California$508.15−$123.23
  6. Hanford, CA · California$508.15−$123.23
  7. Los Angeles, CA · California$544.16−$87.22

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

Every other payment area

47542 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$508.15$114.98
Merced, CACalifornia$508.15$114.98
Modesto, CACalifornia$508.15$114.98
Napa, CACalifornia$594.71$121.91
Oxnard, CACalifornia$542.13$118.11
Redding, CACalifornia$508.15$114.98
Rest of CaliforniaCalifornia$508.15$114.98
Riverside, CACalifornia$511.73$118.57

47542 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.

$418.15

$576.84

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

View every state and territory as a table
47542 office rate range by state
State / territoryOffice rate rangeLocalities
AK$541.631
AL$424.671
AR$418.151
AZ$462.841
CA$508.15–$645.5229
CO$498.481
CT$508.791
DC$548.451
DE$470.851
FL$465.14–$508.073
GA$437.89–$484.412
GU$522.301
HI$522.301
IA$437.691
ID$440.391
IL$449.80–$495.174
IN$443.141
KS$434.781
KY$433.721
LA$432.71–$455.512
MA$494.93–$550.742
MD$480.45–$548.453
ME$442.03–$468.552
MI$445.01–$470.502
MN$478.991
MO$424.33–$458.123
MS$421.371
MT$475.941
NC$447.051
ND$469.421
NE$440.461
NH$489.841
NJ$514.98–$542.102
NM$447.301
NV$474.491
NY$454.08–$561.685
OH$443.681
OK$433.691
OR$471.20–$515.932
PA$444.85–$495.022
PR$479.891
RI$488.821
SC$446.031
SD$468.641
TN$437.001
TX$441.69–$496.478
UT$452.511
VA$466.40–$548.452
VI$479.891
VT$466.801
WA$494.26–$563.052
WI$452.711
WV$431.971
WY$473.101

See 47542 in every payment locality

How the 47542 rate is calculated

Each of 47542’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 · 47542

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.78

2.78 RVUs× 1.000 GPCI

Practice expense11.14

11.14 RVUs× 1.000 GPCI

Malpractice0.33

0.33 RVUs× 1.000 GPCI

Adjusted RVUs

14.2500

Conversion factor

$33.4009

Medicare rate

$475.96

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

The exact Marin County, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,694

Code
47542
Physician work
2.78
Practice expense
11.14
Malpractice
0.33

GPCI2026.csv

25

Locality
Marin County, CA
Physician work
1.095
Practice expense
1.410
Malpractice
0.459
Office calculation for 47542 in Marin County, CA
ComponentRVULocality factorAdjusted
Physician work2.78× 1.0953.0441
Practice expense11.14× 1.41015.7074
Malpractice0.33× 0.4590.1515
Total RVUs18.9030
Conversion factor× 33.4009

Office rate, Marin County, CA$631.38

Office: (2.78 × 1.095 + 11.14 × 1.41 + 0.33 × 0.459) × $33.4009 = $631.38

Facility: (2.78 × 1.095 + 0.4 × 1.41 + 0.33 × 0.459) × $33.4009 = $125.57

Open 47542 in the RVU calculator

Payment rules and modifiers for 47542

The CMS indicators that decide how 47542 is paid alongside other services.

CMS payment indicators · 47542

Biliary dilation, bile duct or ampulla

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
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.

How 47542 has changed in Marin County, CA

47542 · Office / nonfacility

$631.38

Effective 2026-10-01

The base rate is $12.14 higher than on 2025-10-01, moving from $619.24 to $631.38 (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

    $619.24changed to$631.38

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.85 changed to 2.78
    • Practice expense RVU 11.21 changed to 11.14
    • Malpractice RVU 0.29 changed to 0.33
    • Work GPCI 1.088 changed to 1.095
    • Practice expense GPCI 1.419 changed to 1.410
    • Malpractice GPCI 0.470 changed to 0.459

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $651.11changed to$619.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.50 changed to 11.21
    • Malpractice RVU 0.30 changed to 0.29

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $640.49changed to$651.11

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $664.76changed to$640.49

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 11.93 changed to 11.50
    • Malpractice RVU 0.29 changed to 0.30
    • Work GPCI 1.082 changed to 1.088
    • Practice expense GPCI 1.374 changed to 1.419
    • Malpractice GPCI 0.487 changed to 0.470
  5. January 1, 2023

    RVU23A

    $674.90changed to$664.76

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 12.27 changed to 11.93
    • Malpractice RVU 0.25 changed to 0.29
    • Work GPCI 1.077 changed to 1.082
    • Practice expense GPCI 1.329 changed to 1.374
    • Malpractice GPCI 0.504 changed to 0.487

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $683.63changed to$674.90

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 12.52 changed to 12.27
    • Work GPCI 1.071 changed to 1.077
    • Practice expense GPCI 1.311 changed to 1.329

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $661.46changed to$683.63

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 11.67 changed to 12.52
    • Malpractice RVU 0.26 changed to 0.25
    • Work GPCI 1.068 changed to 1.071
    • Practice expense GPCI 1.299 changed to 1.311
    • Malpractice GPCI 0.481 changed to 0.504

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $616.93changed to$661.46

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.82 changed to 11.67
    • Malpractice RVU 0.25 changed to 0.26
    • Work GPCI 1.065 changed to 1.068
    • Practice expense GPCI 1.291 changed to 1.299
    • Malpractice GPCI 0.458 changed to 0.481

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $574.90changed to$616.93

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 10.03 changed to 10.82
    • Work GPCI 1.062 changed to 1.065
    • Practice expense GPCI 1.279 changed to 1.291

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $568.64changed to$574.90

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 10.00 changed to 10.03
    • Work GPCI 1.058 changed to 1.062
    • Practice expense GPCI 1.271 changed to 1.279
    • Malpractice GPCI 0.477 changed to 0.458

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$568.64

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged toNo rate

    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$631.38$125.57RVU26D
2026-07-01$631.38$125.57RVU26C
2026-04-01$631.38$125.57RVU26B
2026-01-01$631.38$125.57RVU26A
2025-10-01$619.24$142.35RVU25D
2025-07-01$619.24$142.35RVU25C
2025-04-01$619.24$142.35RVU25B
2025-01-01$619.24$142.35RVU25A
2024-10-01$651.11$144.75RVU24D
2024-07-01$651.11$144.75RVU24C
2024-04-01$651.11$144.75RVU24B
2024-03-09$651.11$144.75RVU24AR
2024-01-01$640.49$142.39RVU24A
2023-10-01$664.76$147.46RVU23D
2023-07-01$664.76$147.46RVU23C
2023-04-01$664.76$147.46RVU23B
2023-01-01$664.76$147.46RVU23A
2022-10-01$674.90$147.84RVU22D
2022-07-01$674.90$147.84RVU22C
2022-04-01$674.90$147.84RVU22B
2022-01-01$674.90$147.84RVU22A
2021-10-01$683.63$148.41RVU21D
2021-07-01$683.63$148.41RVU21C
2021-04-01$683.63$148.41RVU21B
2021-01-01$683.63$148.41RVU21A
2020-10-01$661.46$154.21RVU20D
2020-07-01$661.46$154.21RVU20C
2020-04-01$661.46$154.21RVU20B
2020-01-01$661.46$154.21RVU20A
2019-10-01$616.93$152.60RVU19D
2019-07-01$616.93$152.60RVU19C
2019-04-01$616.93$152.60RVU19B
2019-01-01$616.93$152.60RVU19A
2018-10-01$574.90$152.22RVU18D
2018-07-01$574.90$152.22RVU18C
2018-04-01$574.90$152.22RVU18B
2018-01-01$574.90$152.22RVU18AR1
2017-10-01$568.64$152.18RVU17D
2017-07-01$568.64$152.18RVU17C
2017-04-01$568.64$152.18RVU17B
2017-01-01$568.64$152.18RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
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 47542 for an earlier date of service

Where the Marin County, CA rate applies

Marin County, CA is a Medicare payment area, not a city. Our Census mapping connects it to 31 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Alto
  • Belvedere
  • Black Point-Green Point
  • Bolinas
  • Corte Madera
  • Dillon Beach
  • Fairfax
  • Inverness

Browse all communities in California

47542 billing questions

Can 47542 be billed by itself?

No. It is an add-on code and must be reported with a qualifying primary procedure for the same intervention.

How is dilation distinguished from biliary stent placement?

47542 describes balloon dilation of a biliary narrowing. Stent-placement services include pre- and post-dilation when performed, so do not separately report 47542 for dilation that is part of that stent service.

What documentation supports reporting 47542?

Document the target duct or ampulla, the narrowing treated, the balloon dilation performed, and the associated primary procedure. The record should clarify when the dilation is separate from work included in that primary service.

Does 47542 have its own global period?

CMS treats it as an add-on paid within the primary procedure’s global period. It is not independently reported outside the primary procedure.

Is 47542 used to remove a bile duct stone?

No. It represents balloon dilation, not calculus extraction. Code 47544 describes percutaneous removal of duct or gallbladder calculi.

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 47542PPRRVU2026_Oct_nonQPP.csv, line 5,694 (RVU26D)
Geographic factors for Marin County, CAGPCI2026.csv, line 25 (RVU26D)

Open CMS sourceHow we calculate rates

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