CPT code 47542: Biliary dilation, bile duct or ampulla2026 Medicare rate & RVUs in Washington, DC area
Percutaneous balloon dilation opens a narrowed bile duct or ampulla during a biliary intervention and is reported only with a qualifying primary procedure.
In Washington, DC area, Medicare pays $548.45 for 47542 in the office and $125.87 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Washington, DC area 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. Washington, DC area pays $548.45. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$548.45
- Los Angeles, CA · California$544.16−$4.29
- Miami, FL · Florida$508.07−$40.38
- Chicago, IL · Illinois$492.75−$55.70
- Manhattan, NY · New York$548.64+$0.19
- Alaska · Alaska$541.63−$6.82
- Alabama · Alabama$424.67−$123.78
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $418.15 | $110.01 |
| ArizonaArizona | $462.84 | $115.24 |
| Bakersfield, CACalifornia | $509.14 | $115.97 |
| Chico, CACalifornia | $508.15 | $114.98 |
| El Centro, CACalifornia | $508.20 | $115.04 |
| Fresno, CACalifornia | $508.15 | $114.98 |
| Hanford, CACalifornia | $508.15 | $114.98 |
| 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 |
| Sacramento, CACalifornia | $534.84 | $117.64 |
| Salinas, CACalifornia | $532.89 | $117.13 |
| San Diego, CACalifornia | $546.63 | $117.59 |
| Marin County, CACalifornia | $631.38 | $125.57 |
| San Francisco, CACalifornia | $631.00 | $125.20 |
| San Benito County, CACalifornia | $645.52 | $128.24 |
| Santa Clara County, CACalifornia | $643.99 | $126.71 |
| San Luis Obispo, CACalifornia | $524.15 | $115.56 |
| Santa Cruz, CACalifornia | $552.80 | $116.95 |
| Santa Maria, CACalifornia | $535.21 | $116.94 |
| Santa Rosa, CACalifornia | $558.47 | $117.95 |
| Stockton, CACalifornia | $508.15 | $114.98 |
| Vallejo, CACalifornia | $594.17 | $121.37 |
| Visalia, CACalifornia | $508.15 | $114.98 |
| Yuba City, CACalifornia | $508.15 | $114.98 |
| ColoradoColorado | $498.48 | $116.79 |
| ConnecticutConnecticut | $508.79 | $122.44 |
| DelawareDelaware | $470.85 | $116.43 |
| Fort Lauderdale, FLFlorida | $489.71 | $126.32 |
| Rest of FloridaFlorida | $465.14 | $122.19 |
| Atlanta, GAGeorgia | $484.41 | $119.94 |
| Rest of GeorgiaGeorgia | $437.89 | $117.91 |
| Hawaii, Guam, HIHawaii | $522.30 | $114.43 |
| IowaIowa | $437.69 | $109.46 |
| IdahoIdaho | $440.39 | $110.36 |
| East St. Louis, ILIllinois | $457.37 | $127.34 |
| Rest of IllinoisIllinois | $449.80 | $122.28 |
| Suburban Chicago, ILIllinois | $495.17 | $126.76 |
| IndianaIndiana | $443.14 | $110.60 |
| KansasKansas | $434.78 | $110.49 |
| KentuckyKentucky | $433.72 | $114.82 |
| New Orleans, LALouisiana | $455.51 | $117.95 |
| Rest of LouisianaLouisiana | $432.71 | $115.24 |
| Metropolitan Boston, MAMassachusetts | $550.74 | $122.42 |
| Rest of MassachusettsMassachusetts | $494.93 | $117.19 |
| Baltimore area, MDMaryland | $507.22 | $122.31 |
| Rest of MarylandMaryland | $480.45 | $117.42 |
| Rest of MaineMaine | $442.03 | $112.00 |
| Southern Maine, MEMaine | $468.55 | $113.05 |
| Detroit, MIMichigan | $470.50 | $124.33 |
| Rest of MichiganMichigan | $445.01 | $117.50 |
| MinnesotaMinnesota | $478.99 | $109.86 |
| Metropolitan Kansas City, MOMissouri | $453.01 | $116.17 |
| Metropolitan St. Louis, MOMissouri | $458.12 | $116.62 |
| Rest of MissouriMissouri | $424.33 | $115.11 |
| MississippiMississippi | $421.37 | $112.50 |
| MontanaMontana | $475.94 | $117.22 |
| North CarolinaNorth Carolina | $447.05 | $112.36 |
| North DakotaNorth Dakota | $469.42 | $110.69 |
| NebraskaNebraska | $440.46 | $109.35 |
| New HampshireNew Hampshire | $489.84 | $116.41 |
| Northern New JerseyNew Jersey | $542.10 | $125.97 |
| Rest of New JerseyNew Jersey | $514.98 | $123.25 |
| New MexicoNew Mexico | $447.30 | $118.34 |
| NevadaNevada | $474.49 | $115.41 |
| NYC suburbs and Long Island, NYNew York | $561.68 | $135.15 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $517.80 | $125.00 |
| Queens, NYNew York | $554.50 | $130.48 |
| Rest of New YorkNew York | $454.08 | $113.30 |
| OhioOhio | $443.68 | $116.16 |
| OklahomaOklahoma | $433.69 | $113.35 |
| Portland, OROregon | $515.93 | $117.38 |
| Rest of OregonOregon | $471.20 | $113.91 |
| Metropolitan Philadelphia, PAPennsylvania | $495.02 | $121.58 |
| Rest of PennsylvaniaPennsylvania | $444.85 | $115.54 |
| Puerto RicoPuerto Rico | $479.89 | $117.22 |
| Rhode IslandRhode Island | $488.82 | $118.25 |
| South CarolinaSouth Carolina | $446.03 | $114.57 |
| South DakotaSouth Dakota | $468.64 | $109.92 |
| TennesseeTennessee | $437.00 | $110.92 |
| Austin, TXTexas | $496.47 | $116.94 |
| Beaumont, TXTexas | $441.69 | $115.25 |
| Brazoria, TXTexas | $470.93 | $115.43 |
| Dallas, TXTexas | $473.75 | $116.45 |
| Fort Worth, TXTexas | $470.17 | $116.46 |
| Galveston, TXTexas | $472.21 | $115.99 |
| Houston, TXTexas | $478.25 | $122.03 |
| Rest of TexasTexas | $455.92 | $115.49 |
| UtahUtah | $452.51 | $115.31 |
| VirginiaVirginia | $466.40 | $113.77 |
| Virgin Islands, VIUnited States Virgin Islands | $479.89 | $117.22 |
| VermontVermont | $466.80 | $111.66 |
| Rest of WashingtonWashington | $494.26 | $116.52 |
| King County, WAWashington | $563.05 | $122.90 |
| WisconsinWisconsin | $452.71 | $109.05 |
| West VirginiaWest Virginia | $431.97 | $120.24 |
| WyomingWyoming | $473.10 | $114.37 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $541.63 | 1 |
| AL | $424.67 | 1 |
| AR | $418.15 | 1 |
| AZ | $462.84 | 1 |
| CA | $508.15–$645.52 | 29 |
| CO | $498.48 | 1 |
| CT | $508.79 | 1 |
| DC | $548.45 | 1 |
| DE | $470.85 | 1 |
| FL | $465.14–$508.07 | 3 |
| GA | $437.89–$484.41 | 2 |
| GU | $522.30 | 1 |
| HI | $522.30 | 1 |
| IA | $437.69 | 1 |
| ID | $440.39 | 1 |
| IL | $449.80–$495.17 | 4 |
| IN | $443.14 | 1 |
| KS | $434.78 | 1 |
| KY | $433.72 | 1 |
| LA | $432.71–$455.51 | 2 |
| MA | $494.93–$550.74 | 2 |
| MD | $480.45–$548.45 | 3 |
| ME | $442.03–$468.55 | 2 |
| MI | $445.01–$470.50 | 2 |
| MN | $478.99 | 1 |
| MO | $424.33–$458.12 | 3 |
| MS | $421.37 | 1 |
| MT | $475.94 | 1 |
| NC | $447.05 | 1 |
| ND | $469.42 | 1 |
| NE | $440.46 | 1 |
| NH | $489.84 | 1 |
| NJ | $514.98–$542.10 | 2 |
| NM | $447.30 | 1 |
| NV | $474.49 | 1 |
| NY | $454.08–$561.68 | 5 |
| OH | $443.68 | 1 |
| OK | $433.69 | 1 |
| OR | $471.20–$515.93 | 2 |
| PA | $444.85–$495.02 | 2 |
| PR | $479.89 | 1 |
| RI | $488.82 | 1 |
| SC | $446.03 | 1 |
| SD | $468.64 | 1 |
| TN | $437.00 | 1 |
| TX | $441.69–$496.47 | 8 |
| UT | $452.51 | 1 |
| VA | $466.40–$548.45 | 2 |
| VI | $479.89 | 1 |
| VT | $466.80 | 1 |
| WA | $494.26–$563.05 | 2 |
| WI | $452.71 | 1 |
| WV | $431.97 | 1 |
| WY | $473.10 | 1 |
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
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 Washington, DC area 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
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.78 | × 1.054 | 2.9301 |
| Practice expense | 11.14 | × 1.178 | 13.1229 |
| Malpractice | 0.33 | × 1.113 | 0.3673 |
| Total RVUs | 16.4203 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$548.45
Office: (2.78 × 1.054 + 11.14 × 1.178 + 0.33 × 1.113) × $33.4009 = $548.45
Facility: (2.78 × 1.054 + 0.4 × 1.178 + 0.33 × 1.113) × $33.4009 = $125.87
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
How 47542 has changed in Washington, DC area
47542 · Office / nonfacility
$548.45
Effective 2026-10-01
The base rate is $7.83 higher than on 2025-10-01, moving from $540.62 to $548.45 (1.4%).
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
$540.62changed to$548.45
- 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 1.057 changed to 1.054
- Practice expense GPCI 1.192 changed to 1.178
- Malpractice GPCI 1.168 changed to 1.113
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$568.25changed to$540.62
- 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.
March 9, 2024
RVU24AR
$558.97changed to$568.25
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$604.87changed to$558.97
- 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 1.056 changed to 1.057
- Practice expense GPCI 1.214 changed to 1.192
- Malpractice GPCI 1.231 changed to 1.168
January 1, 2023
RVU23A
$639.98changed to$604.87
- 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 1.054 changed to 1.056
- Practice expense GPCI 1.236 changed to 1.214
- Malpractice GPCI 1.294 changed to 1.231
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$656.06changed to$639.98
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 12.52 changed to 12.27
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$634.12changed to$656.06
- 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 1.049 changed to 1.054
- Practice expense GPCI 1.221 changed to 1.236
- Malpractice GPCI 1.277 changed to 1.294
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$588.58changed to$634.12
- 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 1.045 changed to 1.049
- Practice expense GPCI 1.205 changed to 1.221
- Malpractice GPCI 1.261 changed to 1.277
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$553.66changed to$588.58
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 10.03 changed to 10.82
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$551.05changed to$553.66
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 10.00 changed to 10.03
- Work GPCI 1.048 changed to 1.045
- Malpractice GPCI 1.271 changed to 1.261
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$622.02changed to$551.05
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 2.50 changed to 2.85
- Practice expense RVU 11.61 changed to 10.00
- Malpractice RVU 0.59 changed to 0.25
- Work GPCI 1.051 changed to 1.048
- Malpractice GPCI 1.280 changed to 1.271
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
No ratechanged to$622.02
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 | $548.45 | $125.87 | RVU26D |
| 2026-07-01 | $548.45 | $125.87 | RVU26C |
| 2026-04-01 | $548.45 | $125.87 | RVU26B |
| 2026-01-01 | $548.45 | $125.87 | RVU26A |
| 2025-10-01 | $540.62 | $140.02 | RVU25D |
| 2025-07-01 | $540.62 | $140.02 | RVU25C |
| 2025-04-01 | $540.62 | $140.02 | RVU25B |
| 2025-01-01 | $540.62 | $140.02 | RVU25A |
| 2024-10-01 | $568.25 | $142.89 | RVU24D |
| 2024-07-01 | $568.25 | $142.89 | RVU24C |
| 2024-04-01 | $568.25 | $142.89 | RVU24B |
| 2024-03-09 | $568.25 | $142.89 | RVU24AR |
| 2024-01-01 | $558.97 | $140.56 | RVU24A |
| 2023-10-01 | $604.87 | $147.82 | RVU23D |
| 2023-07-01 | $604.87 | $147.82 | RVU23C |
| 2023-04-01 | $604.87 | $147.82 | RVU23B |
| 2023-01-01 | $604.87 | $147.82 | RVU23A |
| 2022-10-01 | $639.98 | $149.80 | RVU22D |
| 2022-07-01 | $639.98 | $149.80 | RVU22C |
| 2022-04-01 | $639.98 | $149.80 | RVU22B |
| 2022-01-01 | $639.98 | $149.80 | RVU22A |
| 2021-10-01 | $656.06 | $151.47 | RVU21D |
| 2021-07-01 | $656.06 | $151.47 | RVU21C |
| 2021-04-01 | $656.06 | $151.47 | RVU21B |
| 2021-01-01 | $656.06 | $151.47 | RVU21A |
| 2020-10-01 | $634.12 | $157.33 | RVU20D |
| 2020-07-01 | $634.12 | $157.33 | RVU20C |
| 2020-04-01 | $634.12 | $157.33 | RVU20B |
| 2020-01-01 | $634.12 | $157.33 | RVU20A |
| 2019-10-01 | $588.58 | $155.17 | RVU19D |
| 2019-07-01 | $588.58 | $155.17 | RVU19C |
| 2019-04-01 | $588.58 | $155.17 | RVU19B |
| 2019-01-01 | $588.58 | $155.17 | RVU19A |
| 2018-10-01 | $553.66 | $155.44 | RVU18D |
| 2018-07-01 | $553.66 | $155.44 | RVU18C |
| 2018-04-01 | $553.66 | $155.44 | RVU18B |
| 2018-01-01 | $553.66 | $155.44 | RVU18AR1 |
| 2017-10-01 | $551.05 | $156.22 | RVU17D |
| 2017-07-01 | $551.05 | $156.22 | RVU17C |
| 2017-04-01 | $551.05 | $156.22 | RVU17B |
| 2017-01-01 | $551.05 | $156.22 | RVU17A |
| 2016-10-01 | $622.02 | $155.20 | RVU16D |
| 2016-07-01 | $622.02 | $155.20 | RVU16C |
| 2016-04-01 | $622.02 | $155.20 | RVU16B |
| 2016-01-01 | $622.02 | $155.20 | 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 Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
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
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