$3,808.66–$4,037.74
Use 47538 for percutaneous biliary stent placement. Dilation performed as part of the stent service is included; 47542 is for separately reportable balloon dilation.
On this page
CMS RVU26D · Effective 2026-10-01
47542 Biliary dilation Medicare reimbursement rates in New Jersey
Percutaneous balloon dilation opens a narrowed bile duct or ampulla during a biliary intervention and is reported only with a qualifying primary procedure. Compare 47542 office and facility rates across CMS payment localities in New Jersey.
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.
What does Medicare pay for 47542 in New Jersey?
New Jersey has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$514.98–$542.10
2 of 2 localities have a supported rate.
Facility setting
$123.25–$125.97
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Interventional radiology
About 47542: Percutaneous biliary balloon dilation
Percutaneous balloon dilation opens a narrowed bile duct or ampulla during a biliary intervention and is reported only with a qualifying primary procedure.
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.
CMS billing rules for 47542
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU2.78 · 20%
- Practice expense (office) RVU11.14 · 78%
- Malpractice RVU0.33 · 2%
1K
Medicare services in 2024 · #2946 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.
47542 compared with similar codes
Office rates for New Jersey, from the same CMS release.
$1,204.09–$1,269.90
47533 reports placement of a percutaneous biliary drainage catheter. It can be the primary service accompanying a distinct dilation reported with 47542.
$860.03–$907.92
47544 addresses percutaneous removal of duct or gallbladder calculi; 47542 widens a narrowed duct or ampulla with a balloon.
$403.11–$423.05
47543 reports endoluminal biliary biopsy. It does not represent balloon treatment of a biliary narrowing.
Compare 47542 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Northern Nj →
Office / nonfacility
$542.10
Facility
$125.97
Rest Of New Jersey →
Office / nonfacility
$514.98
Facility
$123.25
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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 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.
5,69147539,,Perq plmt bile duct stent,A,,8.53,109.41,,1.46,,0.99,118.93,10.98,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,69247540,,Perq plmt bile duct stent,A,,8.80,108.70,,1.51,,0.96,118.46,11.27,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,69347541,,Plmt access bil tree sm bwl,A,,6.58,27.98,,1.36,,0.85,35.41,8.79,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,69447542,,Dilate biliary duct/ampulla,A,,2.78,11.14,,0.40,,0.33,14.25,3.51,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,69547543,,Endoluminal bx biliary tree,A,,2.93,7.93,,0.42,,0.33,11.19,3.68,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,69647544,,Removal duct glbldr calculi,A,,3.20,20.16,,0.46,,0.37,23.73,4.03,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,69747550,,Bile duct endoscopy add-on,A,,2.94,0.69,NA,0.69,,0.71,4.34,4.34,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00