CPT code 50236: Kidney and ureter removal, separate incision, bladder cuff2026 Medicare rate & RVUs in Missouri
Reports removal of a kidney, the entire ureter, and a bladder cuff when the ureter is accessed through a separate incision.
CMS doesn’t publish an office rate for 50236 in Missouri.
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 50236 covers
A urologist removes the kidney and its entire ureter, including a cuff of bladder around the ureter’s opening, using a separate incision to reach the distal ureter. This operation is commonly performed in the operating room for upper-tract urothelial cancer when the treatment plan calls for removal of the kidney, full ureter, and bladder cuff. The separate-incision approach distinguishes this service from the corresponding procedure performed through the same incision.
Report the code when the operative report supports removal of all three structures and documents the separate incision. The bladder cuff and ureter removal are part of this operative service, rather than separate components of the same resection. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. A bilateral procedure reported 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 50236 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,285.37 |
| Metropolitan St. Louis, MO | Unavailable | $1,292.31 |
| Rest of Missouri | Unavailable | $1,260.60 |
How the 50236 rate is calculated
Each of 50236’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 · 50236
RVUs × geographic indexes × conversion factor
Work26.27
26.27 RVUs× 1.000 GPCI
Practice expense9.50
9.50 RVUs× 1.000 GPCI
Malpractice3.37
3.37 RVUs× 1.000 GPCI
Adjusted RVUs
39.1400
Conversion factor
$33.4009
Medicare rate
$1,307.31
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 50236
50236 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50236
Kidney and ureter removal, separate 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 · 50236
Kidney and ureter removal, separate 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
50236 without 50 · national facility
$1,307.31
Kidney and ureter removal, separate incision, bladder cuff
50236-50 · Bilateral: 150%
$1,960.97
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).
50236 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 50234Kidney and ureter removalSame-incision bladder cuff
- Both services include the kidney, entire ureter, and bladder cuff. The distinction is whether the distal ureter and cuff are accessed through the same incision or a separate incision.
- 50230Radical nephrectomyOpen, with regional or caval work
- 50230 covers radical nephrectomy with partial ureterectomy. Use 50236 when the operative report documents total ureterectomy, bladder-cuff removal, and a separate incision.
- 50220Kidney removalOpen, nonradical removal
- 50220 includes partial ureterectomy with nephrectomy. It does not represent the full ureter and bladder-cuff removal reported with 50236.
- 50240Kidney surgeryOpen partial resection
- 50240 is a partial nephrectomy that preserves kidney tissue. 50236 represents removal of the kidney together with the entire ureter and a bladder cuff.
50236 billing questions
How is 50236 distinguished from 50234?
Both include kidney removal, complete ureter removal, and a bladder cuff. Use 50236 when the distal ureter and cuff are reached through a separate incision; 50234 describes the same removal through the same incision.
Can the bladder cuff be reported separately?
The bladder cuff removal is included in this service when performed as part of the nephrectomy and total ureterectomy. The operative report should establish that the cuff was removed.
When would 50230 be more appropriate?
50230 describes radical nephrectomy with partial ureterectomy. Choose 50236 when the documented operation removes the entire ureter and bladder cuff through a separate incision.
What documentation supports 50236?
The operative report should document removal of the kidney, the entire ureter, and a bladder cuff, and identify the separate incision used to access the distal ureter.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are other same-session procedures and bilateral reporting handled?
For same-session multiple procedures, Medicare pays the highest-valued procedure in full and others at 50%. A bilateral procedure reported with modifier 50 is paid at 150%.
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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