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

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 Ohio, Medicare pays $443.68 for 47542 in the office and $116.16 when it’s performed in a hospital or facility.

$443.68Office (non-facility)
$116.16Hospital or facility
−6.8%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 Ohio
  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 Ohio 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. Ohio pays $443.68. The RVUs are the same everywhere; the geographic indexes change the dollars.

47542 in Ohio vs other payment areas
  1. Ohio · this page$443.68
  2. Los Angeles, CA · California$544.16+$100.48
  3. Washington, DC area · District of Columbia$548.45+$104.77
  4. Miami, FL · Florida$508.07+$64.39
  5. Chicago, IL · Illinois$492.75+$49.07
  6. Manhattan, NY · New York$548.64+$104.96
  7. Alaska · Alaska$541.63+$97.95

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

Every other payment area

47542 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$424.67$110.78
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

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 Ohio 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

85

Locality
Ohio
Physician work
1.000
Practice expense
0.913
Malpractice
1.008
Office calculation for 47542 in Ohio
ComponentRVULocality factorAdjusted
Physician work2.78× 1.0002.7800
Practice expense11.14× 0.91310.1708
Malpractice0.33× 1.0080.3326
Total RVUs13.2835
Conversion factor× 33.4009

Office rate, Ohio$443.68

Office: (2.78 × 1 + 11.14 × 0.913 + 0.33 × 1.008) × $33.4009 = $443.68

Facility: (2.78 × 1 + 0.4 × 0.913 + 0.33 × 1.008) × $33.4009 = $116.16

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 Ohio

47542 · Office / nonfacility

$443.68

Effective 2026-10-01

The base rate is $11.47 higher than on 2025-10-01, moving from $432.21 to $443.68 (2.7%).

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

    $432.21changed to$443.68

    • 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
    • Practice expense GPCI 0.911 changed to 0.913
    • Malpractice GPCI 1.033 changed to 1.008

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $453.92changed to$432.21

    • 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

    $446.51changed to$453.92

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $475.72changed to$446.51

    • 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
    • Practice expense GPCI 0.912 changed to 0.911
    • Malpractice GPCI 1.063 changed to 1.033
  5. January 1, 2023

    RVU23A

    $495.77changed to$475.72

    • 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
    • Practice expense GPCI 0.913 changed to 0.912
    • Malpractice GPCI 1.094 changed to 1.063

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $507.84changed to$495.77

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 12.52 changed to 12.27

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $498.06changed to$507.84

    • 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
    • Practice expense GPCI 0.915 changed to 0.913
    • Malpractice GPCI 1.049 changed to 1.094

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $469.34changed to$498.06

    • 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
    • Practice expense GPCI 0.917 changed to 0.915
    • Malpractice GPCI 1.005 changed to 1.049

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $442.75changed to$469.34

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 10.03 changed to 10.82

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $440.70changed to$442.75

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 10.00 changed to 10.03
    • Practice expense GPCI 0.918 changed to 0.917
    • Malpractice GPCI 0.999 changed to 1.005

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $492.09changed to$440.70

    • 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
    • Malpractice GPCI 0.993 changed to 0.999

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$492.09

    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$443.68$116.16RVU26D
2026-07-01$443.68$116.16RVU26C
2026-04-01$443.68$116.16RVU26B
2026-01-01$443.68$116.16RVU26A
2025-10-01$432.21$126.04RVU25D
2025-07-01$432.21$126.04RVU25C
2025-04-01$432.21$126.04RVU25B
2025-01-01$432.21$126.04RVU25A
2024-10-01$453.92$128.84RVU24D
2024-07-01$453.92$128.84RVU24C
2024-04-01$453.92$128.84RVU24B
2024-03-09$453.92$128.84RVU24AR
2024-01-01$446.51$126.74RVU24A
2023-10-01$475.72$132.37RVU23D
2023-07-01$475.72$132.37RVU23C
2023-04-01$475.72$132.37RVU23B
2023-01-01$475.72$132.37RVU23A
2022-10-01$495.77$133.68RVU22D
2022-07-01$495.77$133.68RVU22C
2022-04-01$495.77$133.68RVU22B
2022-01-01$495.77$133.68RVU22A
2021-10-01$507.84$135.11RVU21D
2021-07-01$507.84$135.11RVU21C
2021-04-01$507.84$135.11RVU21B
2021-01-01$507.84$135.11RVU21A
2020-10-01$498.06$140.77RVU20D
2020-07-01$498.06$140.77RVU20C
2020-04-01$498.06$140.77RVU20B
2020-01-01$498.06$140.77RVU20A
2019-10-01$469.34$139.53RVU19D
2019-07-01$469.34$139.53RVU19C
2019-04-01$469.34$139.53RVU19B
2019-01-01$469.34$139.53RVU19A
2018-10-01$442.75$139.70RVU18D
2018-07-01$442.75$139.70RVU18C
2018-04-01$442.75$139.70RVU18B
2018-01-01$442.75$139.70RVU18AR1
2017-10-01$440.70$139.91RVU17D
2017-07-01$440.70$139.91RVU17C
2017-04-01$440.70$139.91RVU17B
2017-01-01$440.70$139.91RVU17A
2016-10-01$492.09$136.45RVU16D
2016-07-01$492.09$136.45RVU16C
2016-04-01$492.09$136.45RVU16B
2016-01-01$492.09$136.45RVU16A
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 Ohio rate applies

Ohio is a Medicare payment area, not a city. Our Census mapping connects it to 1265 cities and communities in Ohio. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Ada
  • Adamsville
  • Addyston
  • Adelphi
  • Adena
  • Ai
  • Akron

Browse all communities in Ohio

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 OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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