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See a sample rate comparisonCPT 47542 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Dilate Biliary Duct Ampulla, Balloon Dilation Of Biliary Duct S Or Of Ampulla Sphincteroplasty Percutaneous Including Imaging Guidance Eg Fluoroscopy And All Associated Radiological Supervision And Interpretation Each Duct List Separately In Addition To Code For Primary Procedure
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 47542 |
| Medicaid Fee Schedule | View Medicaid rates for 47542 |
National average reimbursement for CPT 47542 by major payers:
$558.59
$690.79
$709.11
$266.95
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CPT 47542
5 of 25 sample ratesHigher to lower in this preview
Wungki Park
Westchester Medical Center Advanced Physician Services PC
$3,322.32Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$1,358.74Published rateGregg Bean
$742.10Published rateBruce Stein
Floral Park Arthritis PC
$453.39Published rateErin Kelly
Town Center Orthopaedic Associates, P.C.
$184.78Published rate
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See a sample payer proposalCPT 47542 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 47542 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 47542 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 47538-CPT | High | Placement Of Stent(S) Into A Bile Duct Percutaneous Including Diagnostic Cholangiography Imaging Guidance (Eg Fluoroscopyand/Or Ultrasound) Balloon Dilation Catheter Exchange(S) And Catheter Removal(S) When Performed And All Associated Radiological Supervision And Interpretation; Existing Access. (Desc Revised 1/1/2017) |
| 47539-CPT | High | Perq Plmt Bile Duct Stent, Placement Of Stent S Into A Bile Duct Percutaneous Including Diagnostic Cholangiography Imaging Guidance Eg Fluoroscopy And Or Ultrasound Balloon Dilation Catheter Exchange S And Catheter Removal S When Performed And All Associated Radiological Supervision And Interpretation New Access Without Placement Of Separate Biliary Drainage Catheter |
| 47540-CPT | High | Perq Plmt Bile Duct Stent, Placement Of Stent S Into A Bile Duct Percutaneous Including Diagnostic Cholangiography Imaging Guidance Eg Fluoroscopy And Or Ultrasound Balloon Dilation Catheter Exchange S And Catheter Removal S When Performed And All Associated Radiological Supervision And Interpretation New Access With Placement Of Separate Biliary Drainage Catheter Eg External Or Internal External |
| 47542-CPT | Moderate | Dilate Biliary Duct Ampulla, Balloon Dilation Of Biliary Duct S Or Of Ampulla Sphincteroplasty Percutaneous Including Imaging Guidance Eg Fluoroscopy And All Associated Radiological Supervision And Interpretation Each Duct List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 47542. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 47542 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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