No office rate
Use 47490 for percutaneous drainage with imaging guidance; 47480 represents open gallbladder drainage.
On this page
CMS RVU26D · Effective 2026-10-01
47490 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$295.87
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Interventional radiology
About 47490: Percutaneous gallbladder drainage with imaging
Image-guided percutaneous cholecystostomy drains an inflamed or obstructed gallbladder, often when acute illness makes immediate gallbladder removal unsuitable.
This service creates percutaneous access to the gallbladder and places drainage to decompress it, with imaging guidance included in the complete procedure. It is commonly performed by an interventional radiologist in a hospital setting for acute cholecystitis when a patient is too ill or medically high-risk for immediate cholecystectomy. The catheter provides drainage while the acute condition is managed; it is not gallbladder removal.
Report the code for the percutaneous gallbladder procedure, rather than an incision into the bile duct or a surgical gallbladder removal. The operative or procedure report should support the gallbladder as the target, percutaneous access, drainage, and imaging-guided technique. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed 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 inappropriate for this anatomy. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 47490
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.64 · 52%
- Practice expense (office) RVU3.80 · 43%
- Malpractice RVU0.49 · 5%
11.7K
Medicare services in 2024 · #1393 by national volume
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.
47490 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Code 47420 involves an incision into the common bile duct, not percutaneous drainage of the gallbladder.
No office rate
Code 47562 is laparoscopic gallbladder removal. This code drains the gallbladder percutaneously and leaves it in place.
The same code, a different location
How does Delaware compare?
47490 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 47490
Office
Unavailable
Facility
$275.30
No comparable office rate is available.
Arkansas
Arkansas · 47490
Office
Unavailable
Facility
$272.44
No comparable office rate is available.
Arizona
Arizona · 47490
Office
Unavailable
Facility
$291.98
No comparable office rate is available.
Bakersfield
California · 47490
Office
Unavailable
Facility
$307.00
No comparable office rate is available.
Chico
California · 47490
Office
Unavailable
Facility
$305.50
No comparable office rate is available.
El Centro
California · 47490
Office
Unavailable
Facility
$305.58
No comparable office rate is available.
Fresno
California · 47490
Office
Unavailable
Facility
$305.50
No comparable office rate is available.
Hanford-Corcoran
California · 47490
Office
Unavailable
Facility
$305.50
No comparable office rate is available.
Madera
California · 47490
Office
Unavailable
Facility
$305.50
No comparable office rate is available.
Merced
California · 47490
Office
Unavailable
Facility
$305.50
No comparable office rate is available.
Modesto
California · 47490
Office
Unavailable
Facility
$305.50
No comparable office rate is available.
Napa
California · 47490
Office
Unavailable
Facility
$340.34
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 47490
Office
Unavailable
Facility
$319.54
No comparable office rate is available.
Redding
California · 47490
Office
Unavailable
Facility
$305.50
No comparable office rate is available.
Rest Of California
California · 47490
Office
Unavailable
Facility
$305.50
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 47490
Office
Unavailable
Facility
$310.84
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 47490
Office
Unavailable
Facility
$316.94
No comparable office rate is available.
Salinas
California · 47490
Office
Unavailable
Facility
$315.66
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 47490
Office
Unavailable
Facility
$320.30
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 47490
Office
Unavailable
Facility
$356.18
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 47490
Office
Unavailable
Facility
$355.62
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 47490
Office
Unavailable
Facility
$363.82
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 47490
Office
Unavailable
Facility
$361.55
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 47490
Office
Unavailable
Facility
$310.95
No comparable office rate is available.
Santa Cruz-Watsonville
California · 47490
Office
Unavailable
Facility
$321.22
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 47490
Office
Unavailable
Facility
$316.08
No comparable office rate is available.
Santa Rosa-Petaluma
California · 47490
Office
Unavailable
Facility
$324.26
No comparable office rate is available.
Stockton
California · 47490
Office
Unavailable
Facility
$305.50
No comparable office rate is available.
Vallejo
California · 47490
Office
Unavailable
Facility
$339.54
No comparable office rate is available.
Visalia
California · 47490
Office
Unavailable
Facility
$305.50
No comparable office rate is available.
Yuba City
California · 47490
Office
Unavailable
Facility
$305.50
No comparable office rate is available.
Colorado
Colorado · 47490
Office
Unavailable
Facility
$304.67
No comparable office rate is available.
Connecticut
Connecticut · 47490
Office
Unavailable
Facility
$314.58
No comparable office rate is available.
Fort Lauderdale
Florida · 47490
Office
Unavailable
Facility
$313.14
No comparable office rate is available.
Rest Of Florida
Florida · 47490
Office
Unavailable
Facility
$300.92
No comparable office rate is available.
Atlanta
Georgia · 47490
Office
Unavailable
Facility
$304.06
No comparable office rate is available.
Rest Of Georgia
Georgia · 47490
Office
Unavailable
Facility
$287.70
No comparable office rate is available.
Hawaii, Guam
Hawaii · 47490
Office
Unavailable
Facility
$308.77
No comparable office rate is available.
Iowa
Iowa · 47490
Office
Unavailable
Facility
$277.61
No comparable office rate is available.
Idaho
Idaho · 47490
Office
Unavailable
Facility
$279.49
No comparable office rate is available.
East St. Louis
Illinois · 47490
Office
Unavailable
Facility
$304.71
No comparable office rate is available.
Rest Of Illinois
Illinois · 47490
Office
Unavailable
Facility
$296.44
No comparable office rate is available.
Suburban Chicago
Illinois · 47490
Office
Unavailable
Facility
$315.42
No comparable office rate is available.
Indiana
Indiana · 47490
Office
Unavailable
Facility
$280.59
No comparable office rate is available.
Kansas
Kansas · 47490
Office
Unavailable
Facility
$277.97
No comparable office rate is available.
Kentucky
Kentucky · 47490
Office
Unavailable
Facility
$282.79
No comparable office rate is available.
New Orleans
Louisiana · 47490
Office
Unavailable
Facility
$293.01
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 47490
Office
Unavailable
Facility
$282.99
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 47490
Office
Unavailable
Facility
$327.45
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 47490
Office
Unavailable
Facility
$304.15
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 47490
Office
Unavailable
Facility
$313.89
No comparable office rate is available.
Rest Of Maryland
Maryland · 47490
Office
Unavailable
Facility
$300.00
No comparable office rate is available.
Rest Of Maine
Maine · 47490
Office
Unavailable
Facility
$281.93
No comparable office rate is available.
Southern Maine
Maine · 47490
Office
Unavailable
Facility
$291.09
No comparable office rate is available.
Detroit
Michigan · 47490
Office
Unavailable
Facility
$305.06
No comparable office rate is available.
Rest Of Michigan
Michigan · 47490
Office
Unavailable
Facility
$289.34
No comparable office rate is available.
Minnesota
Minnesota · 47490
Office
Unavailable
Facility
$290.43
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 47490
Office
Unavailable
Facility
$290.15
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 47490
Office
Unavailable
Facility
$292.21
No comparable office rate is available.
Rest Of Missouri
Missouri · 47490
Office
Unavailable
Facility
$280.33
No comparable office rate is available.
Mississippi
Mississippi · 47490
Office
Unavailable
Facility
$276.36
No comparable office rate is available.
Montana**
Montana · 47490
Office
Unavailable
Facility
$298.24
No comparable office rate is available.
North Carolina
North Carolina · 47490
Office
Unavailable
Facility
$283.86
No comparable office rate is available.
North Dakota**
North Dakota · 47490
Office
Unavailable
Facility
$288.55
No comparable office rate is available.
Nebraska
Nebraska · 47490
Office
Unavailable
Facility
$278.32
No comparable office rate is available.
New Hampshire
New Hampshire · 47490
Office
Unavailable
Facility
$301.43
No comparable office rate is available.
Northern Nj
New Jersey · 47490
Office
Unavailable
Facility
$329.45
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 47490
Office
Unavailable
Facility
$317.73
No comparable office rate is available.
New Mexico
New Mexico · 47490
Office
Unavailable
Facility
$291.03
No comparable office rate is available.
Nevada**
Nevada · 47490
Office
Unavailable
Facility
$295.66
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 47490
Office
Unavailable
Facility
$346.20
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 47490
Office
Unavailable
Facility
$320.74
No comparable office rate is available.
Queens
New York · 47490
Office
Unavailable
Facility
$338.52
No comparable office rate is available.
Rest Of New York
New York · 47490
Office
Unavailable
Facility
$287.06
No comparable office rate is available.
Ohio
Ohio · 47490
Office
Unavailable
Facility
$287.36
No comparable office rate is available.
Oklahoma
Oklahoma · 47490
Office
Unavailable
Facility
$281.04
No comparable office rate is available.
Portland
Oregon · 47490
Office
Unavailable
Facility
$310.65
No comparable office rate is available.
Rest Of Oregon
Oregon · 47490
Office
Unavailable
Facility
$292.90
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 47490
Office
Unavailable
Facility
$309.42
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 47490
Office
Unavailable
Facility
$286.96
No comparable office rate is available.
Puerto Rico
Puerto Rico · 47490
Office
Unavailable
Facility
$299.42
No comparable office rate is available.
Rhode Island
Rhode Island · 47490
Office
Unavailable
Facility
$303.64
No comparable office rate is available.
South Carolina
South Carolina · 47490
Office
Unavailable
Facility
$286.17
No comparable office rate is available.
South Dakota**
South Dakota · 47490
Office
Unavailable
Facility
$287.40
No comparable office rate is available.
Tennessee
Tennessee · 47490
Office
Unavailable
Facility
$279.14
No comparable office rate is available.
Austin
Texas · 47490
Office
Unavailable
Facility
$304.08
No comparable office rate is available.
Beaumont
Texas · 47490
Office
Unavailable
Facility
$285.68
No comparable office rate is available.
Brazoria
Texas · 47490
Office
Unavailable
Facility
$294.77
No comparable office rate is available.
Dallas
Texas · 47490
Office
Unavailable
Facility
$296.83
No comparable office rate is available.
Fort Worth
Texas · 47490
Office
Unavailable
Facility
$295.78
No comparable office rate is available.
Galveston
Texas · 47490
Office
Unavailable
Facility
$295.81
No comparable office rate is available.
Houston
Texas · 47490
Office
Unavailable
Facility
$304.78
No comparable office rate is available.
Rest Of Texas
Texas · 47490
Office
Unavailable
Facility
$290.21
No comparable office rate is available.
Utah
Utah · 47490
Office
Unavailable
Facility
$288.99
No comparable office rate is available.
Virginia
Virginia · 47490
Office
Unavailable
Facility
$291.30
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 47490
Office
Unavailable
Facility
$299.42
No comparable office rate is available.
Vermont
Vermont · 47490
Office
Unavailable
Facility
$288.92
No comparable office rate is available.
Rest Of Washington
Washington · 47490
Office
Unavailable
Facility
$303.10
No comparable office rate is available.
Seattle (King Cnty)
Washington · 47490
Office
Unavailable
Facility
$331.84
No comparable office rate is available.
Wisconsin
Wisconsin · 47490
Office
Unavailable
Facility
$281.61
No comparable office rate is available.
West Virginia
West Virginia · 47490
Office
Unavailable
Facility
$288.70
No comparable office rate is available.
Wyoming**
Wyoming · 47490
Office
Unavailable
Facility
$294.01
No comparable office rate is available.
See how rates vary across the country
47490 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 47490 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$325.46
$295.87 × 110% = $325.46
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 47490 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
5,682
- Code
- 47490
- Physician work
- 4.64
- Practice expense
- 3.80
- Malpractice
- 0.49
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.64 | × 1.005 | 4.6632 |
| Practice expense | 3.80 | × 0.988 | 3.7544 |
| Malpractice | 0.49 | × 0.899 | 0.4405 |
| Total RVUs | 8.8581 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$295.87
Open 47490 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.64 | 1.005 |
| Practice expense | 3.8 | 0.988 |
| Malpractice | 0.49 | 0.899 |
(4.64 × 1.005 + 3.8 × 0.988 + 0.49 × 0.899) × $33.4009 = $295.87
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
47490 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $295.87 | RVU26D |
| 2026-07-01 | Not available in this setting | $295.87 | RVU26C |
| 2026-04-01 | Not available in this setting | $295.87 | RVU26B |
| 2026-01-01 | Not available in this setting | $295.87 | RVU26A |
| 2025-10-01 | Not available in this setting | $318.64 | RVU25D |
| 2025-07-01 | Not available in this setting | $318.64 | RVU25C |
| 2025-04-01 | Not available in this setting | $318.64 | RVU25B |
| 2025-01-01 | Not available in this setting | $318.64 | RVU25A |
47490 billing questions
How does this differ from 47480?
This code describes percutaneous gallbladder drainage with imaging guidance. Code 47480 is the open approach.
Can imaging guidance be billed separately?
Imaging guidance is included in the complete percutaneous procedure. Do not separately report guidance for the same access and drainage service.
Should modifier 50 be appended for a gallbladder procedure?
No. The gallbladder anatomy makes modifier 50 inappropriate for this code.
Are related postoperative visits separately reported during the global period?
Related postoperative visits for 10 days are included in the minor-procedure global period.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is statutorily restricted for this code. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,67947425,,Incision of bile duct,A,,21.75,10.89,NA,10.89,,5.82,38.46,38.46,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,68047460,,Incise bile duct sphincter,A,,20.01,10.46,NA,10.46,,5.34,35.81,35.81,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,68147480,,Incision of gallbladder,A,,12.92,8.98,NA,8.98,,3.18,25.08,25.08,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,68247490,,Incision of gallbladder,A,,4.64,3.80,NA,3.80,,0.49,8.93,8.93,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,68347531,,Injection for cholangiogram,A,,1.27,10.52,,0.44,,0.14,11.93,1.85,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,68447532,,Injection for cholangiogram,A,,4.14,19.60,,0.84,,0.49,24.23,5.47,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,68547533,,Plmt biliary drainage cath,A,,5.25,27.44,,0.97,,0.57,33.26,6.79,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503