CPT code 47543: Biliary biopsy, percutaneous endoluminal sampling2026 Medicare rate & RVUs in Massachusetts
Reports percutaneous tissue sampling from inside the biliary tree, such as biopsy of a duct lesion or stricture during a biliary intervention.
Medicare pays $387.12–$427.94 for 47543 in the office in Massachusetts, from Rest of Massachusetts to Metropolitan Boston, MA. 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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What 47543 covers
An interventional radiologist or other qualified physician obtains tissue from within the bile ducts through percutaneous biliary access. Sampling may use a brush, forceps, needle, or another method, and may target a suspicious duct lesion or a stricture being evaluated for a cause. The code covers single or multiple samples; the route is through the skin rather than through the gastrointestinal tract.
Select this service when tissue biopsy of the biliary tree is performed, not merely diagnostic inspection or cytology collection by brushing or washing. Document the biliary site sampled, the percutaneous route, the biopsy method, and the clinical reason for tissue evaluation. This is an add-on code: report it only with a primary procedure, and CMS payment falls within that primary procedure’s global period. The primary procedure and biopsy should be supported by the operative or procedure record.
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 47543 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | $427.94 | $128.44 |
| Rest of Massachusetts | $387.12 | $122.99 |
How the 47543 rate is calculated
Each of 47543’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 · 47543
RVUs × geographic indexes × conversion factor
Work2.93
2.93 RVUs× 1.000 GPCI
Practice expense7.93
7.93 RVUs× 1.000 GPCI
Malpractice0.33
0.33 RVUs× 1.000 GPCI
Adjusted RVUs
11.1900
Conversion factor
$33.4009
Medicare rate
$373.76
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 47543
The CMS indicators that decide how 47543 is paid alongside other services.
CMS payment indicators · 47543
Biliary biopsy, percutaneous endoluminal sampling
| 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. |
47543 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 47552Biliary endoscopyDiagnostic, through existing access
- 47552 describes diagnostic percutaneous biliary endoscopy with optional brushing or washing. Choose 47543 when tissue biopsy is performed.
- 47542Biliary dilationBile duct or ampulla
- 47542 is for dilation of a biliary duct or the ampulla. It does not describe tissue sampling, though dilation and biopsy may occur in one session.
- 47544Biliary stone removalPercutaneous extraction
- 47544 addresses removal of calculi from the bile duct or gallbladder. Use 47543 for tissue sampling, not stone removal.
47543 billing questions
When should this code be selected instead of 47552?
Use 47543 for tissue biopsy from within the biliary tree. Code 47552 describes percutaneous diagnostic biliary endoscopy with or without brushing or washing for specimen collection.
Can 47543 be reported by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure; payment is within that procedure’s global period.
Does one code cover multiple biopsy samples?
Yes. The code covers single or multiple samples, so the number of tissue bites or specimens does not by itself determine the code.
What documentation supports reporting the biopsy?
Document the percutaneous biliary route, the duct site or lesion sampled, the sampling method, and the reason tissue was obtained.
Is brushing or washing alone enough to report 47543?
No. The service is for endoluminal tissue biopsy. Brushing or washing for specimen collection during diagnostic biliary endoscopy is described by 47552.
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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