Billing code 47534: Biliary drainageMedicare rate & RVUs in Nevada

Reports image-guided percutaneous placement of an internal-external biliary drainage catheter, typically to drain an obstructed bile duct through both internal and external routes.

CMS RVU26DEffective Oct 1, 20261 payment locality3.7K Medicare services in 2024

Medicare pays $1,214.50 for 47534 in the office in Nevada (Nevada**). Which amount applies depends on the service address.

$1,214.50Office (non-facility)
$312.44Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 47534 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Nevada
  2. What 47534 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 47534 covers

An interventional radiologist or other qualified physician accesses the biliary tree through the skin and liver, evaluates the ducts with cholangiography, and places a catheter that permits bile to drain internally into the bowel and externally through the catheter. This approach may be used for biliary obstruction when drainage across the obstructed segment is feasible and external access is also needed. The service is commonly performed in a hospital imaging or interventional suite.

Report this code for placement of the internal-external drainage catheter, not for an external-only catheter. The service includes diagnostic cholangiography and imaging guidance with associated radiological supervision and interpretation; document the access route, catheter position and drainage configuration. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are 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.

47534 in Nevada**

47534 office and facility rates by payment locality
Payment localityOfficeFacility
Nevada**$1,214.50$312.44

How the 47534 rate is calculated

Each of 47534’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 · 47534

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.41Practice expense 28.24Malpractice 0.82

36.4700 adjusted RVUs×$33.4009 conversion factor=$1,218.13

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 47534

The CMS indicators that decide how 47534 is paid alongside other services.

CMS payment indicators · 47534

Biliary drainage

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

47534 without 51 · national office

$1,218.13

Biliary drainage

47534-51 · Second procedure: 50%

$609.07

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%).

When to use modifier 51

47534 compared with similar codes

Compare codes

47534 vs 47533 vs 47535 vs 47536 vs 47538: national Medicare rates

Swap in your local Medicare rate.

  • 47534
    Biliary drainage · 7.41 wRVU
    $1,218.13
  • 47533
    Biliary drainage · 5.25 wRVU
    $1,110.91−$107.22
  • 47535
    Biliary catheter conversion · 3.85 wRVU
    $848.38−$369.75
  • 47536
    Biliary catheter exchange · 2.54 wRVU
    $604.56−$613.57
  • 47538
    Biliary stent · 4.63 wRVU
    $3,495.07+$2,276.94

How to choose

47533Biliary drainage
Choose 47534 when the catheter drains both internally into the bowel and externally. Choose 47533 for an external-only drainage catheter.
47535Biliary catheter conversion
47535 describes conversion of an existing external biliary drainage catheter to an internal-external catheter; 47534 reports placement of the catheter.
47536Biliary catheter exchange
47536 is for exchange of an existing biliary drainage catheter, not placement of a new internal-external drainage catheter.
47538Biliary stent
47538 reports percutaneous biliary stent placement. Use 47534 when the service places an internal-external drainage catheter rather than a stent.

47534 billing questions

How does this differ from 47533?

47534 is for an internal-external catheter, which drains into the bowel and also provides external drainage. 47533 is for an external drainage catheter.

Can the cholangiogram or imaging guidance be billed separately?

Diagnostic cholangiography and imaging guidance associated with catheter placement are included in this service. Do not separately report them as though they were independent services.

Should modifier 50 be appended for bilateral drainage?

No. The biliary drainage service is not reported as a paired-side procedure, and modifier 50 is inappropriate.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple-procedure reduction.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

What documentation supports reporting 47534?

Document the percutaneous access, cholangiographic evaluation, catheter position, and that the catheter provides both internal and external drainage.

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
RVUs for 47534PPRRVU2026_Oct_nonQPP.csv, line 5,686 (RVU26D)
Geographic factors for Nevada**GPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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