CPT 47535
Global 000 ActiveConversion ext bil drg cath
CPT 47535 Billing & Documentation Guide
CPT code 47535 (Conversion ext bil drg cath) is classified under Surgery (Digestive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.85, a non-facility practice expense RVU of 21.12, and a malpractice RVU of 0.43, a total non-facility RVU of 25.4 and facility RVU of 5.07. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $879.72, though rates vary from $741.95 to $1167.66 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 47535, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 47535 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 47535 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 47535
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.85 | 3.85 |
| Practice Expense RVU | 21.12 | 0.79 |
| Malpractice RVU | 0.43 | 0.43 |
| Total RVU | 25.4 | 5.07 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 47535
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $975.71 | $172.21 | $911.63 - $1167.66 | 29 |
| Florida | $864.33 | $183.03 | $824.57 - $899.27 | 3 |
| Georgia | $818.95 | $171.14 | $774.95 - $862.94 | 2 |
| Illinois | $838.11 | $181.98 | $795.1 - $879.42 | 4 |
| Michigan | $811.2 | $173.59 | $788.86 - $833.55 | 2 |
| North Carolina | $795.93 | $162.39 | $795.93 - $795.93 | 1 |
| New York | $941.19 | $183.65 | $808.85 - $1002.25 | 5 |
| Ohio | $787.13 | $167.16 | $787.13 - $787.13 | 1 |
| Pennsylvania | $836.07 | $170.95 | $789.75 - $882.39 | 2 |
| Texas | $837.13 | $168.62 | $783.87 - $887.92 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 47535
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 47535 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 47535
What does CPT code 47535 mean? +
CPT code 47535 represents: Conversion ext bil drg cath. It's in the Surgery (Digestive) category with a global period of 000.
What is the Medicare reimbursement for CPT 47535? +
The 2026 Medicare national average non-facility payment for CPT 47535 is $879.72. Rates range from $741.95 to $1167.66 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 47535? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 47535? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team