Billing code 47542: Biliary dilationMedicare rate & RVUs
Percutaneous balloon dilation opens a narrowed bile duct or ampulla during a biliary intervention and is reported only with a qualifying primary procedure.
Medicare pays $475.96 for 47542 nationally in the office and $117.24 in a hospital or facility. Local office rates run $418.15–$645.52.
Medicare rate · 47542
Biliary dilation
Swap in your local Medicare rate.
- Work RVUs
- 2.78
- Total RVUs
- 14.25
- Global days
- ZZZ
National rate · 2026
$475.96
Office setting, before claim adjustments.
See every locality for 47542 → · 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 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.
Where 47542 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
$418.15 to $645.52
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $424.67 | $110.78 |
| Alaska* | $541.63 | $159.58 |
| Arizona | $462.84 | $115.24 |
| Arkansas | $418.15 | $110.01 |
| Atlanta | $484.41 | $119.94 |
| Austin | $496.47 | $116.94 |
| Bakersfield | $509.14 | $115.97 |
| Baltimore/Surr. Cntys | $507.22 | $122.31 |
| Beaumont | $441.69 | $115.25 |
| Brazoria | $470.93 | $115.43 |
| Chicago | $492.75 | $132.23 |
| Chico | $508.15 | $114.98 |
| Colorado | $498.48 | $116.79 |
| Connecticut | $508.79 | $122.44 |
| Dallas | $473.75 | $116.45 |
| Dc + Md/Va Suburbs | $548.45 | $125.87 |
| Delaware | $470.85 | $116.43 |
| Detroit | $470.50 | $124.33 |
| East St. Louis | $457.37 | $127.34 |
| El Centro | $508.20 | $115.04 |
| Fort Lauderdale | $489.71 | $126.32 |
| Fort Worth | $470.17 | $116.46 |
| Fresno | $508.15 | $114.98 |
| Galveston | $472.21 | $115.99 |
| Hanford-Corcoran | $508.15 | $114.98 |
| Hawaii, Guam | $522.30 | $114.43 |
| Houston | $478.25 | $122.03 |
| Idaho | $440.39 | $110.36 |
| Indiana | $443.14 | $110.60 |
| Iowa | $437.69 | $109.46 |
| Kansas | $434.78 | $110.49 |
| Kentucky | $433.72 | $114.82 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $544.16 | $119.79 |
| Madera | $508.15 | $114.98 |
| Manhattan | $548.64 | $131.80 |
| Merced | $508.15 | $114.98 |
| Metropolitan Boston | $550.74 | $122.42 |
| Metropolitan Kansas City | $453.01 | $116.17 |
| Metropolitan Philadelphia | $495.02 | $121.58 |
| Metropolitan St. Louis | $458.12 | $116.62 |
| Miami | $508.07 | $134.64 |
| Minnesota | $478.99 | $109.86 |
| Mississippi | $421.37 | $112.50 |
| Modesto | $508.15 | $114.98 |
| Montana** | $475.94 | $117.22 |
| Napa | $594.71 | $121.91 |
| Nebraska | $440.46 | $109.35 |
| Nevada** | $474.49 | $115.41 |
| New Hampshire | $489.84 | $116.41 |
| New Mexico | $447.30 | $118.34 |
| New Orleans | $455.51 | $117.95 |
| North Carolina | $447.05 | $112.36 |
| North Dakota** | $469.42 | $110.69 |
| Northern Nj | $542.10 | $125.97 |
| Nyc Suburbs/Long Island | $561.68 | $135.15 |
| Ohio | $443.68 | $116.16 |
| Oklahoma | $433.69 | $113.35 |
| Oxnard-Thousand Oaks-Ventura | $542.13 | $118.11 |
| Portland | $515.93 | $117.38 |
| Poughkpsie/N Nyc Suburbs | $517.80 | $125.00 |
| Puerto Rico | $479.89 | $117.22 |
| Queens | $554.50 | $130.48 |
| Redding | $508.15 | $114.98 |
| Rest Of California | $508.15 | $114.98 |
| Rest Of Florida | $465.14 | $122.19 |
| Rest Of Georgia | $437.89 | $117.91 |
| Rest Of Illinois | $449.80 | $122.28 |
| Rest Of Louisiana | $432.71 | $115.24 |
| Rest Of Maine | $442.03 | $112.00 |
| Rest Of Maryland | $480.45 | $117.42 |
| Rest Of Massachusetts | $494.93 | $117.19 |
| Rest Of Michigan | $445.01 | $117.50 |
| Rest Of Missouri | $424.33 | $115.11 |
| Rest Of New Jersey | $514.98 | $123.25 |
| Rest Of New York | $454.08 | $113.30 |
| Rest Of Oregon | $471.20 | $113.91 |
| Rest Of Pennsylvania | $444.85 | $115.54 |
| Rest Of Texas | $455.92 | $115.49 |
| Rest Of Washington | $494.26 | $116.52 |
| Rhode Island | $488.82 | $118.25 |
| Riverside-San Bernardino-Ontario | $511.73 | $118.57 |
| Sacramento-Roseville-Folsom | $534.84 | $117.64 |
| Salinas | $532.89 | $117.13 |
| San Diego-Chula Vista-Carlsbad | $546.63 | $117.59 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $631.38 | $125.57 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $631.00 | $125.20 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $645.52 | $128.24 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $643.99 | $126.71 |
| San Luis Obispo-Paso Robles | $524.15 | $115.56 |
| Santa Cruz-Watsonville | $552.80 | $116.95 |
| Santa Maria-Santa Barbara | $535.21 | $116.94 |
| Santa Rosa-Petaluma | $558.47 | $117.95 |
| Seattle (King Cnty) | $563.05 | $122.90 |
| South Carolina | $446.03 | $114.57 |
| South Dakota** | $468.64 | $109.92 |
| Southern Maine | $468.55 | $113.05 |
| Stockton | $508.15 | $114.98 |
| Suburban Chicago | $495.17 | $126.76 |
| Tennessee | $437.00 | $110.92 |
| Utah | $452.51 | $115.31 |
| Vallejo | $594.17 | $121.37 |
| Vermont | $466.80 | $111.66 |
| Virgin Islands | $479.89 | $117.22 |
| Virginia | $466.40 | $113.77 |
| Visalia | $508.15 | $114.98 |
| West Virginia | $431.97 | $120.24 |
| Wisconsin | $452.71 | $109.05 |
| Wyoming** | $473.10 | $114.37 |
| Yuba City | $508.15 | $114.98 |
47542 rates by state
Office rate range in each state. Select a state to see its payment localities.
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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
Swap in your local Medicare rate.
Work 2.78Practice expense 11.14Malpractice 0.33
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 47542
The CMS indicators that decide how 47542 is paid alongside other services.
CMS payment indicators · 47542
Biliary dilation
| 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. |
47542 compared with similar codes
Compare codes
47542 vs 47538 vs 47533 vs 47544 vs 47543: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 47538Biliary stent
- Use 47538 for percutaneous biliary stent placement. Dilation performed as part of the stent service is included; 47542 is for separately reportable balloon dilation.
- 47533Biliary drainage
- 47533 reports placement of a percutaneous biliary drainage catheter. It can be the primary service accompanying a distinct dilation reported with 47542.
- 47544Biliary stone removal
- 47544 addresses percutaneous removal of duct or gallbladder calculi; 47542 widens a narrowed duct or ampulla with a balloon.
- 47543Biliary biopsy
- 47543 reports endoluminal biliary biopsy. It does not represent balloon treatment of a biliary narrowing.
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
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