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 Gallbladder drainage Medicare reimbursement rates in Vermont
Image-guided percutaneous cholecystostomy drains an inflamed or obstructed gallbladder, often when acute illness makes immediate gallbladder removal unsuitable. Compare 47490 office and facility rates across CMS payment localities in Vermont.
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 47490 in Vermont?
Vermont has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$288.92
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
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 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 Vermont, 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.
Compare 47490 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.
1 of 1 payment localities
Vermont →
Office / nonfacility
Unavailable
Facility
$288.92
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 Vermont.
PPRRVU2026_Oct_nonQPP.csv
5,682
- Code
- 47490
- Physician work
- 4.64
- Practice expense
- 3.80
- Malpractice
- 0.49
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.64 | × 1.000 | 4.6400 |
| Practice expense | 3.80 | × 0.990 | 3.7620 |
| Malpractice | 0.49 | × 0.506 | 0.2479 |
| Total RVUs | 8.6499 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$288.92
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.64 | 1 |
| Practice expense | 3.8 | 0.99 |
| Malpractice | 0.49 | 0.506 |
(4.64 × 1 + 3.8 × 0.99 + 0.49 × 0.506) × $33.4009 = $288.92
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.
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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817