CPT code 50234: Kidney and ureter removal, same-incision bladder cuff2026 Medicare rate & RVUs in California
Reports removal of a kidney, the entire ureter, and a bladder cuff through the same incision, commonly for upper tract urothelial malignancy.
CMS doesn’t publish an office rate for 50234 in California.
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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What 50234 covers
A urologist removes the kidney together with the full ureter and a cuff of bladder around the ureter’s opening, completing the removal through the same incision. This operation is commonly performed for upper tract urothelial carcinoma involving the renal pelvis or ureter. It is generally an operating-room procedure in a hospital setting.
Report this code when the operative record supports removal of the entire ureter and bladder cuff through the same incision; removal of only part of the ureter or use of a separate incision points to a different code. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others 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 payment 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 50234 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $1,160.40 |
| Chico, CA | Unavailable | $1,151.12 |
| El Centro, CA | Unavailable | $1,151.65 |
| Fresno, CA | Unavailable | $1,151.12 |
| Hanford, CA | Unavailable | $1,151.12 |
| Los Angeles, CA | Unavailable | $1,207.09 |
| Madera, CA | Unavailable | $1,151.12 |
| Marin County, CA | Unavailable | $1,289.46 |
| Merced, CA | Unavailable | $1,151.12 |
| Modesto, CA | Unavailable | $1,151.12 |
| Napa, CA | Unavailable | $1,244.56 |
| Oxnard, CA | Unavailable | $1,192.30 |
| Redding, CA | Unavailable | $1,151.12 |
| Rest of California | Unavailable | $1,151.12 |
| Riverside, CA | Unavailable | $1,185.37 |
| Sacramento, CA | Unavailable | $1,184.22 |
| Salinas, CA | Unavailable | $1,179.22 |
| San Benito County, CA | Unavailable | $1,318.04 |
| San Diego, CA | Unavailable | $1,189.13 |
| San Francisco, CA | Unavailable | $1,285.87 |
| San Luis Obispo, CA | Unavailable | $1,162.81 |
| Santa Clara County, CA | Unavailable | $1,303.37 |
| Santa Cruz, CA | Unavailable | $1,186.61 |
| Santa Maria, CA | Unavailable | $1,178.77 |
| Santa Rosa, CA | Unavailable | $1,197.19 |
| Stockton, CA | Unavailable | $1,151.12 |
| Vallejo, CA | Unavailable | $1,239.38 |
| Visalia, CA | Unavailable | $1,151.12 |
| Yuba City, CA | Unavailable | $1,151.12 |
How the 50234 rate is calculated
Each of 50234’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 · 50234
RVUs × geographic indexes × conversion factor
Work23.45
23.45 RVUs× 1.000 GPCI
Practice expense8.14
8.14 RVUs× 1.000 GPCI
Malpractice3.16
3.16 RVUs× 1.000 GPCI
Adjusted RVUs
34.7500
Conversion factor
$33.4009
Medicare rate
$1,160.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 50234
50234 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50234
Kidney and ureter removal, same-incision bladder cuff
| 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 · 50234
Kidney and ureter removal, same-incision bladder cuff
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
50234 without 50 · national facility
$1,160.68
Kidney and ureter removal, same-incision bladder cuff
50234-50 · Bilateral: 150%
$1,741.02
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).
50234 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 50236Kidney and ureter removalSeparate incision, bladder cuff
- Both include removal of the kidney, entire ureter, and bladder cuff. Choose 50234 when removal is through the same incision; 50236 describes a separate incision.
- 50220Kidney removalOpen, nonradical removal
- 50220 covers kidney removal with partial ureterectomy. Use 50234 when the entire ureter and a bladder cuff are removed through the same incision.
- 50230Radical nephrectomyOpen, with regional or caval work
- 50230 describes radical nephrectomy with partial ureterectomy. It does not represent the total ureter and bladder cuff removal captured by 50234.
- 50240Kidney surgeryOpen partial resection
- 50240 is a partial nephrectomy that preserves part of the kidney; 50234 removes the kidney along with the entire ureter and bladder cuff.
50234 billing questions
How does this code differ from 50236?
The distinction is the incision: 50234 describes kidney, entire ureter, and bladder cuff removal through the same incision; 50236 is for a separate incision.
Is the bladder cuff included?
Yes. The service includes removal of the bladder cuff along with the kidney and entire ureter.
What operative documentation supports this code?
Document removal of the kidney, the entire ureter, and the bladder cuff, and specify that the procedure was completed through the same incision.
How is bilateral surgery reported?
CMS identifies this as a bilateral procedure; reporting modifier 50 is paid at 150%.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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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