Billing code 47538: Biliary stentMedicare rate & RVUs
Percutaneous placement of a biliary stent in the initial duct to restore bile drainage, typically for an obstructing stricture or other blockage.
Medicare pays $3,495.07 for 47538 nationally in the office and $202.08 in a hospital or facility. Local office rates run $3,018.33–$4,973.42.
Medicare rate · 47538
Biliary stent
Swap in your local Medicare rate.
- Work RVUs
- 4.63
- Total RVUs
- 104.64
- Global days
- 000
National rate · 2026
$3,495.07
Office setting, before claim adjustments.
See every locality for 47538 → · Billed by an NP, PA or therapist? →
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 10 sections
What 47538 covers
An interventional radiologist typically places a stent through a percutaneous, often transhepatic, route to keep an obstructed bile duct open and allow bile to drain. Common clinical settings include biliary strictures and malignant obstruction. Imaging guidance and intraprocedural cholangiography, when performed, are part of the service; the code is for the initial duct treated, not a drainage catheter exchange or removal.
Report this code for stent placement in the initial duct and document the access route, treated duct, obstruction or stricture, and stent placement. Same-day preoperative and postoperative care is included in the 0-day global period. If multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is not appropriate for this service. Medicare does not pay for an assistant at surgery, co-surgeons, or team surgery 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 47538 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$3018.33 to $4973.42
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $3,072.36 | $190.99 |
| Alaska* | $3,780.94 | $273.90 |
| Arizona | $3,389.63 | $198.72 |
| Arkansas | $3,018.33 | $189.64 |
| Atlanta | $3,552.07 | $206.39 |
| Austin | $3,686.25 | $202.26 |
| Bakersfield | $3,810.56 | $201.43 |
| Baltimore/Surr. Cntys | $3,744.13 | $210.75 |
| Beaumont | $3,194.75 | $198.12 |
| Brazoria | $3,462.72 | $199.36 |
| Chicago | $3,534.40 | $224.94 |
| Chico | $3,809.03 | $199.91 |
| Colorado | $3,705.99 | $202.24 |
| Connecticut | $3,757.60 | $211.04 |
| Dallas | $3,480.80 | $200.97 |
| Dc + Md/Va Suburbs | $4,096.93 | $217.78 |
| Delaware | $3,454.27 | $200.79 |
| Detroit | $3,390.20 | $212.46 |
| East St. Louis | $3,246.11 | $216.55 |
| El Centro | $3,809.11 | $199.99 |
| Fort Lauderdale | $3,551.77 | $215.97 |
| Fort Worth | $3,447.78 | $200.88 |
| Fresno | $3,809.03 | $199.91 |
| Galveston | $3,470.17 | $200.23 |
| Hanford-Corcoran | $3,809.03 | $199.91 |
| Hawaii, Guam | $3,943.39 | $199.25 |
| Houston | $3,479.32 | $209.38 |
| Idaho | $3,220.37 | $190.82 |
| Indiana | $3,243.85 | $191.25 |
| Iowa | $3,202.48 | $189.39 |
| Kansas | $3,167.71 | $190.84 |
| Kentucky | $3,124.72 | $197.25 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $4,104.04 | $208.43 |
| Madera | $3,809.03 | $199.91 |
| Manhattan | $4,053.20 | $226.74 |
| Merced | $3,809.03 | $199.91 |
| Metropolitan Boston | $4,144.38 | $212.54 |
| Metropolitan Kansas City | $3,291.94 | $199.82 |
| Metropolitan Philadelphia | $3,637.35 | $209.34 |
| Metropolitan St. Louis | $3,335.56 | $200.63 |
| Miami | $3,656.88 | $228.87 |
| Minnesota | $3,579.70 | $191.21 |
| Mississippi | $3,028.71 | $193.45 |
| Modesto | $3,809.03 | $199.91 |
| Montana** | $3,495.04 | $202.04 |
| Napa | $4,553.54 | $213.37 |
| Nebraska | $3,228.76 | $189.32 |
| Nevada** | $3,495.60 | $199.32 |
| New Hampshire | $3,629.26 | $201.25 |
| New Mexico | $3,222.56 | $202.88 |
| New Orleans | $3,301.24 | $202.53 |
| North Carolina | $3,266.35 | $193.99 |
| North Dakota** | $3,485.15 | $192.16 |
| Northern Nj | $4,037.74 | $217.87 |
| Nyc Suburbs/Long Island | $4,147.46 | $232.09 |
| Ohio | $3,206.04 | $199.54 |
| Oklahoma | $3,135.71 | $195.06 |
| Oxnard-Thousand Oaks-Ventura | $4,098.02 | $205.70 |
| Portland | $3,862.20 | $203.69 |
| Poughkpsie/N Nyc Suburbs | $3,821.29 | $215.46 |
| Puerto Rico | $3,531.38 | $202.16 |
| Queens | $4,117.27 | $224.95 |
| Redding | $3,809.03 | $199.91 |
| Rest Of California | $3,809.03 | $199.91 |
| Rest Of Florida | $3,357.23 | $209.12 |
| Rest Of Georgia | $3,139.31 | $201.96 |
| Rest Of Illinois | $3,215.31 | $208.80 |
| Rest Of Louisiana | $3,112.14 | $197.84 |
| Rest Of Maine | $3,222.86 | $193.30 |
| Rest Of Maryland | $3,535.13 | $202.62 |
| Rest Of Massachusetts | $3,670.31 | $202.79 |
| Rest Of Michigan | $3,208.06 | $201.56 |
| Rest Of Missouri | $3,035.96 | $197.40 |
| Rest Of New Jersey | $3,808.66 | $212.71 |
| Rest Of New York | $3,323.92 | $195.58 |
| Rest Of Oregon | $3,476.82 | $196.99 |
| Rest Of Pennsylvania | $3,221.61 | $198.64 |
| Rest Of Texas | $3,323.94 | $198.89 |
| Rest Of Washington | $3,669.25 | $201.72 |
| Rhode Island | $3,605.89 | $204.22 |
| Riverside-San Bernardino-Ontario | $3,814.48 | $205.35 |
| Sacramento-Roseville-Folsom | $4,034.66 | $204.90 |
| Salinas | $4,020.59 | $204.01 |
| San Diego-Chula Vista-Carlsbad | $4,143.51 | $205.09 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $4,863.45 | $220.33 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $4,862.89 | $219.76 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $4,973.42 | $224.92 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $4,971.10 | $222.60 |
| San Luis Obispo-Paso Robles | $3,951.95 | $201.23 |
| Santa Cruz-Watsonville | $4,205.17 | $204.18 |
| Santa Maria-Santa Barbara | $4,043.39 | $203.76 |
| Santa Rosa-Petaluma | $4,249.77 | $205.97 |
| Seattle (King Cnty) | $4,254.23 | $213.73 |
| South Carolina | $3,239.96 | $197.23 |
| South Dakota** | $3,483.98 | $190.99 |
| Southern Maine | $3,458.99 | $195.64 |
| Stockton | $3,809.03 | $199.91 |
| Suburban Chicago | $3,598.79 | $216.88 |
| Tennessee | $3,184.88 | $191.55 |
| Utah | $3,293.94 | $198.53 |
| Vallejo | $4,552.72 | $212.55 |
| Vermont | $3,453.58 | $193.52 |
| Virgin Islands | $3,531.38 | $202.16 |
| Virginia | $3,433.66 | $196.64 |
| Visalia | $3,809.03 | $199.91 |
| West Virginia | $3,066.86 | $205.25 |
| Wisconsin | $3,343.92 | $189.23 |
| Wyoming** | $3,490.73 | $197.73 |
| Yuba City | $3,809.03 | $199.91 |
47538 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.
$3,018.33
$4,391.23
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 | $3,780.94 | 1 |
| AL | $3,072.36 | 1 |
| AR | $3,018.33 | 1 |
| AZ | $3,389.63 | 1 |
| CA | $3,809.03–$4,973.42 | 29 |
| CO | $3,705.99 | 1 |
| CT | $3,757.60 | 1 |
| DC | $4,096.93 | 1 |
| DE | $3,454.27 | 1 |
| FL | $3,357.23–$3,656.88 | 3 |
| GA | $3,139.31–$3,552.07 | 2 |
| GU | $3,943.39 | 1 |
| HI | $3,943.39 | 1 |
| IA | $3,202.48 | 1 |
| ID | $3,220.37 | 1 |
| IL | $3,215.31–$3,598.79 | 4 |
| IN | $3,243.85 | 1 |
| KS | $3,167.71 | 1 |
| KY | $3,124.72 | 1 |
| LA | $3,112.14–$3,301.24 | 2 |
| MA | $3,670.31–$4,144.38 | 2 |
| MD | $3,535.13–$4,096.93 | 3 |
| ME | $3,222.86–$3,458.99 | 2 |
| MI | $3,208.06–$3,390.20 | 2 |
| MN | $3,579.70 | 1 |
| MO | $3,035.96–$3,335.56 | 3 |
| MS | $3,028.71 | 1 |
| MT | $3,495.04 | 1 |
| NC | $3,266.35 | 1 |
| ND | $3,485.15 | 1 |
| NE | $3,228.76 | 1 |
| NH | $3,629.26 | 1 |
| NJ | $3,808.66–$4,037.74 | 2 |
| NM | $3,222.56 | 1 |
| NV | $3,495.60 | 1 |
| NY | $3,323.92–$4,147.46 | 5 |
| OH | $3,206.04 | 1 |
| OK | $3,135.71 | 1 |
| OR | $3,476.82–$3,862.20 | 2 |
| PA | $3,221.61–$3,637.35 | 2 |
| PR | $3,531.38 | 1 |
| RI | $3,605.89 | 1 |
| SC | $3,239.96 | 1 |
| SD | $3,483.98 | 1 |
| TN | $3,184.88 | 1 |
| TX | $3,194.75–$3,686.25 | 8 |
| UT | $3,293.94 | 1 |
| VA | $3,433.66–$4,096.93 | 2 |
| VI | $3,531.38 | 1 |
| VT | $3,453.58 | 1 |
| WA | $3,669.25–$4,254.23 | 2 |
| WI | $3,343.92 | 1 |
| WV | $3,066.86 | 1 |
| WY | $3,490.73 | 1 |
How the 47538 rate is calculated
Each of 47538’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 · 47538
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.63Practice expense 99.51Malpractice 0.50
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 47538
The CMS indicators that decide how 47538 is paid alongside other services.
CMS payment indicators · 47538
Biliary stent
| 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
47538 without 51 · national office
$3,495.07
Biliary stent
47538-51 · Second procedure: 50%
$1,747.54
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%).
47538 compared with similar codes
Compare codes
47538 vs 47533 vs 47536 vs 47539 vs 47537: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 47533Biliary drainage
- Choose 47533 when the service places a biliary drainage catheter. Choose 47538 when a stent is placed in the initial duct.
- 47536Biliary catheter exchange
- 47536 describes exchange of an existing biliary drainage catheter; 47538 describes placement of a biliary stent in the initial duct.
- 47539Biliary stent
- 47538 is for the initial duct treated with a stent. Code 47539 addresses stent placement in an additional duct.
- 47537Biliary catheter removal
- 47537 describes removal of a biliary drainage catheter. It is not the code for placing a biliary stent.
47538 billing questions
How does this differ from a biliary drainage catheter placement?
This code is for placing a stent to maintain duct patency. Codes 47533 and 47534 describe placement of biliary drainage catheters, rather than the stent service.
Can the cholangiography or imaging guidance be billed separately?
Imaging guidance and intraprocedural cholangiography, when performed as part of the stent placement, are included in this service.
What supports reporting this code?
Document the percutaneous access, the duct treated, the clinical obstruction or stricture, and placement of the stent in the initial duct.
Should modifier 50 be appended for bilateral duct treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the applicable duct-level service rather than using modifier 50.
How are other procedures in the same session paid?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay for an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.
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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