CPT code 50365: Kidney transplant, with recipient nephrectomy2026 Medicare rate & RVUs in Guam
Reports transplantation of a donor kidney when the recipient's native kidney is also removed as part of the transplant operation.
CMS doesn’t publish an office rate for 50365 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 50365 covers
A transplant surgeon uses this code for a donor kidney implanted in a recipient when a recipient nephrectomy is performed as part of the same transplant operation. The service is generally performed in a hospital operating room. The recipient nephrectomy is included in this transplant service; it is not a separate nephrectomy performed independently of the transplant.
Choose this code instead of 50360 when the transplant operation includes removal of the recipient's kidney; 50360 describes the transplant without recipient nephrectomy. The operative report should support the transplant and the recipient nephrectomy performed during that operation. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 pays this bilateral procedure at 150%. Assistant-at-surgery payment, co-surgeons, and team surgery are 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.
50365 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | $2,752.62 |
How the 50365 rate is calculated
Each of 50365’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 · 50365
RVUs × geographic indexes × conversion factor
Work44.98
44.98 RVUs× 1.000 GPCI
Practice expense26.78
26.78 RVUs× 1.000 GPCI
Malpractice12.06
12.06 RVUs× 1.000 GPCI
Adjusted RVUs
83.8200
Conversion factor
$33.4009
Medicare rate
$2,799.66
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 50365
50365 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50365
Kidney transplant, with recipient nephrectomy
| 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) | 2 | Permitted. |
| Team surgery (66) | 2 | 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 · 50365
Kidney transplant, with recipient nephrectomy
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
50365 without 50 · national facility
$2,799.66
Kidney transplant, with recipient nephrectomy
50365-50 · Bilateral: 150%
$4,199.49
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).
50365 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 50360Kidney transplantWithout recipient nephrectomy
- Both describe kidney allotransplantation, but 50365 includes recipient nephrectomy during the transplant operation; 50360 is for transplantation without it.
- 50340Recipient nephrectomyNative kidney removal
- 50340 describes recipient nephrectomy as a separate service. When nephrectomy is performed as part of kidney allotransplantation, use 50365 instead.
- 50370Allograft removalTransplanted kidney
- 50370 describes removal of a previously transplanted renal allograft, not implantation of a donor kidney with recipient nephrectomy.
- 50380Kidney transplantPatient's own kidney
- 50380 describes autotransplantation of the patient's own kidney; 50365 is for transplantation of a donor kidney.
50365 billing questions
How does this differ from 50360?
Use 50365 when recipient nephrectomy is performed as part of the kidney transplant. Use 50360 for the transplant without recipient nephrectomy.
Can the recipient nephrectomy be reported separately?
The recipient nephrectomy is included when performed as part of the transplant reported with 50365. Document it in the operative report as part of the transplant operation.
What does the 90-day global period include?
CMS includes the day-before preoperative visit and 90 days of related postoperative care in the global period for 50365.
How is modifier 50 handled?
CMS pays 50365 with modifier 50 at 150% for a bilateral procedure. The operative documentation should support the bilateral service.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made for 50365, and CMS permits co-surgeons and team surgery.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and the other procedures at 50% when performed in the same session.
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
Show the CMS file lines behind this rate
Fee sheets · Coming soon
Put 50365 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist