Billing code 47554: Biliary endoscopyMedicare rate & RVUs in Guam
Report percutaneous biliary endoscopy with stone removal when a clinician uses endoscopic access through the skin to clear biliary duct calculi.
CMS doesn’t publish an office rate for 47554 in Guam.
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 9 sections
What 47554 covers
This service uses an endoscope passed through a percutaneous route to directly examine the biliary ducts and remove one or more stones. Interventional radiologists commonly perform it in a hospital facility, including when duct stones need treatment through percutaneous biliary access rather than an endoscopic route through the digestive tract. The service is distinct from diagnostic inspection or biopsy alone: the endoscopic procedure includes calculus removal.
Select the code when documentation supports percutaneous biliary endoscopy and stone extraction, rather than a different therapeutic endoscopic maneuver or nonendoscopic calculus removal. The record should identify the access route, biliary site, stones treated, and removal performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Bilateral adjustment is inappropriate. Assistant-at-surgery services are not paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
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.
47554 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $387.13 |
How the 47554 rate is calculated
Each of 47554’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 · 47554
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.82Practice expense 1.80Malpractice 1.25
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 47554
The CMS indicators that decide how 47554 is paid alongside other services.
CMS payment indicators · 47554
Biliary endoscopy
| 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 | 3 | Endoscopy family rules apply. |
| 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) | 1 | Permitted with supporting documentation. |
| 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
47554 without 51 · national facility
$396.47
Biliary endoscopy
47554-51 · Second procedure: 50%
$198.24
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%).
47554 compared with similar codes
Compare codes
47554 vs 47552 vs 47553 vs 47544: national Medicare rates
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How to choose
- 47552Biliary endoscopy
- 47552 is for diagnostic percutaneous biliary endoscopy, including specimen collection when performed. Choose 47554 when the endoscopic service includes removing biliary stones.
- 47553Biliary endoscopy
- 47553 centers on biopsy during percutaneous biliary endoscopy. 47554 is selected when calculus removal is performed.
- 47544Biliary stone removal
- 47544 represents percutaneous calculus removal without the endoscopic service described by 47554. Base the choice on whether the documented procedure includes biliary endoscopy.
47554 billing questions
How does 47554 differ from diagnostic biliary endoscopy?
Use 47554 when the percutaneous endoscopic service includes removal of biliary calculi. Diagnostic inspection or specimen collection without stone removal points to the diagnostic endoscopy code instead.
How is 47554 different from 47544?
47554 describes stone removal performed as part of percutaneous biliary endoscopy. 47544 describes percutaneous calculus removal without the endoscopic service represented by 47554.
Can a related biliary endoscopy be reported during the same session?
Related endoscopies performed together are subject to CMS endoscopy family pricing. The documentation should identify each service actually performed.
Should modifier 50 be used for stones in both sides of the biliary tree?
No. CMS identifies bilateral adjustment as inappropriate for this code; its descriptor or anatomy makes modifier 50 unsuitable.
Can an assistant or co-surgeon be paid for this procedure?
Assistant-at-surgery services are not paid. Co-surgeons are paid only when supporting documentation is submitted; team surgery is not permitted.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care.
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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