CPT code 50230: Radical nephrectomy, open, with regional or caval work2026 Medicare rate & RVUs

Medicare pays $1,142.64 for 50230 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 50230 covers

Code 50230 represents open radical kidney removal with partial removal of the adjacent ureter and regional lymph-node dissection, vena caval tumor-thrombus removal, or both, as indicated. Urologists typically perform it in a hospital operating room for renal malignancy requiring this extent of surgery, such as disease involving regional nodes or extending into the vena cava. It is distinct from limited kidney excision and diagnostic biopsy.

Choose the code based on the operation performed, not the diagnosis alone. The operative report should support the open approach, nephrectomy extent, partial ureter removal, and any regional lymphadenectomy or caval thrombectomy. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. In a same-session multiple-procedure claim, 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 made, co-surgeons are permitted, 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 50230 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

50230 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 50230 rate is calculated

Each of 50230’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.

Payment rules and modifiers for 50230

50230 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

50230 compared with similar codes

How to choose

50220Kidney removalOpen, nonradical removal

Use 50220 for open kidney removal with partial ureterectomy when the procedure does not include the regional lymphadenectomy and/or vena caval thrombectomy that distinguishes 50230.

50225NephrectomyComplicated removal

50225 identifies open nephrectomy involving extensive lysis of perirenal adhesions. 50230 is distinguished by regional lymphadenectomy and/or vena caval thrombectomy.

50234Kidney and ureter removalSame-incision bladder cuff

Compare the operative extent: 50234 is a kidney-and-ureter removal code, while 50230 describes radical nephrectomy with regional nodal and/or caval thrombus work.

50240Kidney surgeryOpen partial resection

50240 is for partial nephrectomy, which removes part of the kidney; 50230 is the radical nephrectomy option with regional nodal and/or caval work.

Codes related to 50230

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates