CPT code 50225: Nephrectomy, complicated removal2026 Medicare rate & RVUs
Reports a complex kidney removal when prior surgery, radiotherapy, or infection makes nephrectomy more difficult than a routine removal.
Medicare pays $1,059.48 for 50225 nationally in a facility.
Medicare rate · 50225
Nephrectomy, complicated removal
- Work RVUs
- 21.33
- Total RVUs
- 31.72
- Global days
- 090
National rate · 2026
$1,059.48
Facility setting, before claim adjustments.
See every locality for 50225 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 10 sections
What 50225 covers
This code describes a complex nephrectomy, including partial ureter removal when performed as part of the kidney removal. It is used when prior surgery, radiotherapy, or infection complicates the operation; examples include dense operative scarring or an infected kidney. Urologists typically perform the procedure in a hospital operating room. The operative report should identify the complicating condition and explain how it affected the dissection or removal, rather than relying on the diagnosis alone.
Select this code for the complex removal rather than routine nephrectomy when the documented circumstances support the added complexity. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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.
Where 50225 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Unavailable | $987.71 |
| Alaska | Unavailable | $1,391.04 |
| Arizona | Unavailable | $1,038.34 |
| Arkansas | Unavailable | $978.95 |
| Atlanta, GA | Unavailable | $1,084.16 |
| Austin, TX | Unavailable | $1,065.23 |
| Bakersfield, CA | Unavailable | $1,061.60 |
| Baltimore area, MD | Unavailable | $1,111.27 |
| Beaumont, TX | Unavailable | $1,029.99 |
| Brazoria, TX | Unavailable | $1,042.67 |
| Chicago, IL | Unavailable | $1,184.69 |
| Chico, CA | Unavailable | $1,053.47 |
| Colorado | Unavailable | $1,064.24 |
| Connecticut | Unavailable | $1,112.66 |
| Dallas, TX | Unavailable | $1,051.82 |
| Delaware | Unavailable | $1,050.70 |
| Detroit, MI | Unavailable | $1,113.56 |
| East St. Louis, IL | Unavailable | $1,132.20 |
| El Centro, CA | Unavailable | $1,053.93 |
| Fort Lauderdale, FL | Unavailable | $1,137.01 |
| Fort Worth, TX | Unavailable | $1,050.47 |
| Fresno, CA | Unavailable | $1,053.47 |
| Galveston, TX | Unavailable | $1,047.59 |
| Hanford, CA | Unavailable | $1,053.47 |
| Hawaii, Guam, HI | Unavailable | $1,055.77 |
| Houston, TX | Unavailable | $1,097.93 |
| Idaho | Unavailable | $990.66 |
| Indiana | Unavailable | $993.64 |
| Iowa | Unavailable | $982.40 |
| Kansas | Unavailable | $989.42 |
| Kentucky | Unavailable | $1,023.34 |
| King County, WA | Unavailable | $1,136.22 |
| Los Angeles, CA | Unavailable | $1,104.52 |
| Madera, CA | Unavailable | $1,053.47 |
| Manhattan, NY | Unavailable | $1,200.24 |
| Marin County, CA | Unavailable | $1,182.09 |
| Merced, CA | Unavailable | $1,053.47 |
| Metropolitan Boston, MA | Unavailable | $1,128.09 |
| Metropolitan Kansas City, MO | Unavailable | $1,041.80 |
| Metropolitan Philadelphia, PA | Unavailable | $1,100.49 |
| Metropolitan St. Louis, MO | Unavailable | $1,047.41 |
| Miami, FL | Unavailable | $1,210.38 |
| Minnesota | Unavailable | $1,002.21 |
| Mississippi | Unavailable | $1,000.03 |
| Modesto, CA | Unavailable | $1,053.47 |
| Montana | Unavailable | $1,059.29 |
| Napa, CA | Unavailable | $1,140.32 |
| Nebraska | Unavailable | $982.70 |
| Nevada | Unavailable | $1,044.39 |
| New Hampshire | Unavailable | $1,058.46 |
| New Mexico | Unavailable | $1,056.76 |
| New Orleans, LA | Unavailable | $1,056.91 |
| North Carolina | Unavailable | $1,009.22 |
| North Dakota | Unavailable | $1,004.92 |
| Northern New Jersey | Unavailable | $1,151.44 |
| NYC suburbs and Long Island, NY | Unavailable | $1,232.02 |
| Ohio | Unavailable | $1,038.01 |
| Oklahoma | Unavailable | $1,011.69 |
| Oxnard, CA | Unavailable | $1,091.24 |
| Portland, OR | Unavailable | $1,075.69 |
| Poughkeepsie and northern NYC suburbs, NY | Unavailable | $1,135.07 |
| Puerto Rico | Unavailable | $1,060.91 |
| Queens, NY | Unavailable | $1,192.11 |
| Redding, CA | Unavailable | $1,053.47 |
| Rest of California | Unavailable | $1,053.47 |
| Rest of Florida | Unavailable | $1,094.45 |
| Rest of Georgia | Unavailable | $1,049.55 |
| Rest of Illinois | Unavailable | $1,088.99 |
| Rest of Louisiana | Unavailable | $1,026.27 |
| Rest of Maine | Unavailable | $1,004.34 |
| Rest of Maryland | Unavailable | $1,062.13 |
| Rest of Massachusetts | Unavailable | $1,065.75 |
| Rest of Michigan | Unavailable | $1,049.12 |
| Rest of Missouri | Unavailable | $1,021.87 |
| Rest of New Jersey | Unavailable | $1,120.36 |
| Rest of New York | Unavailable | $1,019.44 |
| Rest of Oregon | Unavailable | $1,031.18 |
| Rest of Pennsylvania | Unavailable | $1,033.50 |
| Rest of Texas | Unavailable | $1,037.55 |
| Rest of Washington | Unavailable | $1,060.31 |
| Rhode Island | Unavailable | $1,071.51 |
| Riverside, CA | Unavailable | $1,083.30 |
| Sacramento, CA | Unavailable | $1,084.10 |
| Salinas, CA | Unavailable | $1,079.52 |
| San Benito County, CA | Unavailable | $1,208.02 |
| San Diego, CA | Unavailable | $1,088.80 |
| San Francisco, CA | Unavailable | $1,178.97 |
| San Luis Obispo, CA | Unavailable | $1,064.44 |
| Santa Clara County, CA | Unavailable | $1,195.25 |
| Santa Cruz, CA | Unavailable | $1,086.68 |
| Santa Maria, CA | Unavailable | $1,079.17 |
| Santa Rosa, CA | Unavailable | $1,096.41 |
| South Carolina | Unavailable | $1,026.30 |
| South Dakota | Unavailable | $998.49 |
| Southern Maine, ME | Unavailable | $1,023.29 |
| Stockton, CA | Unavailable | $1,053.47 |
| Suburban Chicago, IL | Unavailable | $1,142.26 |
| Tennessee | Unavailable | $993.73 |
| Utah | Unavailable | $1,034.80 |
| Vallejo, CA | Unavailable | $1,135.82 |
| Vermont | Unavailable | $1,011.55 |
| Virgin Islands, VI | Unavailable | $1,060.91 |
| Virginia | Unavailable | $1,028.13 |
| Visalia, CA | Unavailable | $1,053.47 |
| Washington, DC area | Unavailable | $1,153.75 |
| West Virginia | Unavailable | $1,065.64 |
| Wisconsin | Unavailable | $985.20 |
| Wyoming | Unavailable | $1,035.59 |
| Yuba City, CA | Unavailable | $1,053.47 |
50225 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 50225 rate is calculated
Each of 50225’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 · 50225
RVUs × geographic indexes × conversion factor
Work21.33
21.33 RVUs× 1.000 GPCI
Practice expense7.64
7.64 RVUs× 1.000 GPCI
Malpractice2.75
2.75 RVUs× 1.000 GPCI
Adjusted RVUs
31.7200
Conversion factor
$33.4009
Medicare rate
$1,059.48
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 50225
50225 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50225
Nephrectomy, complicated removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 50225
Nephrectomy, complicated removal
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
50225 without 50 · national facility
$1,059.48
Nephrectomy, complicated removal
50225-50 · Bilateral: 150%
$1,589.22
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
50225 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 50220Kidney removalOpen, nonradical removal
- 50220 describes nephrectomy without the complicating circumstances specified for 50225. Choose 50225 when prior surgery, radiotherapy, or infection makes the operation complex and the operative report supports that distinction.
- 50230Radical nephrectomyOpen, with regional or caval work
- 50230 describes radical nephrectomy with regional lymphadenectomy. It is selected for that operative extent, rather than for complexity alone.
- 50234Kidney and ureter removalSame-incision bladder cuff
- 50234 is for removal of the kidney and ureter through the same incision. Use 50225 for complex nephrectomy when the operative service is not that more extensive kidney-and-ureter removal.
- 50240Kidney surgeryOpen partial resection
- 50240 describes partial nephrectomy, preserving part of the kidney. Code 50225 represents complex removal of the kidney.
50225 billing questions
How does this differ from routine nephrectomy code 50220?
Use 50225 when prior surgery, radiotherapy, or infection complicates the kidney removal. Use 50220 for a nephrectomy without those documented complicating circumstances.
What documentation supports the complex code?
Document the prior surgery, radiotherapy, or infection and describe how it made the nephrectomy more difficult. A diagnosis without an operative explanation may not establish the complexity.
Is partial ureter removal separately reported?
Partial ureter removal performed as part of the nephrectomy is included in the service. A more extensive kidney-and-ureter removal is represented by a different procedure code.
How is bilateral reporting handled?
For a bilateral procedure, report modifier 50; CMS pays the service at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; CMS does not permit team-surgery payment for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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
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