CPT code 50431: Antegrade contrast study, new access2026 Medicare rate & RVUs in Oklahoma

Reports a contrast study of the renal collecting system and ureter performed through newly established percutaneous access to assess drainage, patency, or obstruction.

CMS RVU26DEffective Oct 1, 2026One payment locality5.1K Medicare services in 2024

In Oklahoma, Medicare pays $278.36 for 50431 in the office and $56.15 when it’s performed in a hospital or facility.

$278.36Office (non-facility)
$56.15Hospital or facility
−9.6%vs the national office rate ($307.96)

Check a contract rate as a % of Medicare · 50431 nationwide

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

We’ll open 50431 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Oklahoma
  2. What 50431 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 50431 covers

An antegrade nephrostogram or ureterogram traces contrast from the kidney’s collecting system down the ureter. Code 50431 identifies a diagnostic study reached by creating new percutaneous access, rather than injecting contrast through an already-present nephrostomy catheter. An interventional radiologist or urologist typically uses ultrasound or fluoroscopy to guide access, injects contrast, and interprets the images in an interventional radiology suite or hospital procedure room. The study can help clarify suspected obstruction, a leak, or impaired drainage.

Report 50431 when the new access is used for the contrast examination and a catheter placement service does not account for the work. Nephrostomy or nephroureteral catheter placement codes include the diagnostic contrast study when performed, so do not separately report 50431 for that included imaging. Document the indication, newly obtained access, contrast examination, findings, and laterality. CMS assigns a 0-day global period, including same-day preoperative and postoperative care. For bilateral service, modifier 50 is paid at 150%. In a session with multiple procedures, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is barred; co-surgeon and team-surgery billing are 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.

How Oklahoma compares for 50431

Across 109 of 109 payment localities, the office rate for 50431 runs from $268.19 in Arkansas to $428.58 in San Benito County, CA. Oklahoma pays $278.36. The RVUs are the same everywhere; the geographic indexes change the dollars.

50431 in Oklahoma vs other payment areas
  1. Oklahoma · this page$278.36
  2. Los Angeles, CA · California$357.16+$78.80
  3. Washington, DC area · District of Columbia$358.08+$79.72
  4. Miami, FL · Florida$325.08+$46.72
  5. Chicago, IL · Illinois$314.74+$36.38
  6. Manhattan, NY · New York$356.04+$77.68
  7. Alaska · Alaska$341.46+$63.10

Other areas in Oklahoma first, then benchmark localities. Bars start at $0.

Every other payment area

50431 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$272.69$54.96
ArkansasArkansas$268.19$54.44
ArizonaArizona$299.06$57.94
Bakersfield, CACalifornia$332.82$60.09
Chico, CACalifornia$332.45$59.73
El Centro, CACalifornia$332.47$59.75
Fresno, CACalifornia$332.45$59.73
Hanford, CACalifornia$332.45$59.73

50431 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$268.19

$380.52

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
50431 office rate range by state
State / territoryOffice rate rangeLocalities
AK$341.461
AL$272.691
AR$268.191
AZ$299.061
CA$332.45–$428.5829
CO$324.671
CT$330.161
DC$358.081
DE$304.511
FL$298.17–$325.083
GA$279.76–$313.162
GU$343.011
HI$343.011
IA$282.741
ID$284.391
IL$286.88–$318.544
IN$286.321
KS$280.221
KY$277.841
LA$276.94–$292.682
MA$321.93–$361.012
MD$311.20–$358.083
ME$284.98–$304.062
MI$285.14–$301.322
MN$312.911
MO$270.84–$295.093
MS$269.631
MT$307.951
NC$288.541
ND$305.581
NE$284.811
NH$318.451
NJ$334.45–$353.392
NM$286.501
NV$307.561
NY$293.36–$364.375
OH$284.651
OK$278.361
OR$305.69–$337.272
PA$285.74–$320.372
PR$310.851
RI$317.051
SC$286.971
SD$305.291
TN$281.691
TX$283.53–$323.138
UT$291.451
VA$302.22–$358.082
VI$310.851
VT$303.291
WA$321.68–$369.892
WI$293.921
WV$274.551
WY$306.911

See 50431 in every payment locality

How the 50431 rate is calculated

Each of 50431’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 · 50431

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.07

1.07 RVUs× 1.000 GPCI

Practice expense8.03

8.03 RVUs× 1.000 GPCI

Malpractice0.12

0.12 RVUs× 1.000 GPCI

Adjusted RVUs

9.2200

Conversion factor

$33.4009

Medicare rate

$307.96

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Oklahoma inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,918

Code
50431
Physician work
1.07
Practice expense
8.03
Malpractice
0.12

GPCI2026.csv

86

Locality
Oklahoma
Physician work
1.000
Practice expense
0.893
Malpractice
0.777
Office calculation for 50431 in Oklahoma
ComponentRVULocality factorAdjusted
Physician work1.07× 1.0001.0700
Practice expense8.03× 0.8937.1708
Malpractice0.12× 0.7770.0932
Total RVUs8.3340
Conversion factor× 33.4009

Office rate, Oklahoma$278.36

Office: (1.07 × 1 + 8.03 × 0.893 + 0.12 × 0.777) × $33.4009 = $278.36

Facility: (1.07 × 1 + 0.58 × 0.893 + 0.12 × 0.777) × $33.4009 = $56.15

Open 50431 in the RVU calculator

Payment rules and modifiers for 50431

The CMS indicators that decide how 50431 is paid alongside other services.

CMS payment indicators · 50431

Antegrade contrast study, new access

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

50431 without 50 · national office

$307.96

Antegrade contrast study, new access

50431-50 · Bilateral: 150%

$461.94

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).

When to use modifier 50

How 50431 has changed in Oklahoma

50431 · Office / nonfacility

$278.36

Effective 2026-10-01

The base rate is $7.35 higher than on 2025-10-01, moving from $271.01 to $278.36 (2.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $271.01changed to$278.36

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.10 changed to 1.07
    • Practice expense RVU 8.05 changed to 8.03
    • Malpractice RVU 0.13 changed to 0.12
    • Practice expense GPCI 0.891 changed to 0.893
    • Malpractice GPCI 0.813 changed to 0.777

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $286.33changed to$271.01

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.31 changed to 8.05
    • Malpractice RVU 0.12 changed to 0.13

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $281.66changed to$286.33

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $296.66changed to$281.66

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.54 changed to 8.31
    • Malpractice RVU 0.11 changed to 0.12
    • Practice expense GPCI 0.886 changed to 0.891
    • Malpractice GPCI 0.798 changed to 0.813
  5. January 1, 2023

    RVU23A

    $308.46changed to$296.66

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.78 changed to 8.54
    • Malpractice RVU 0.10 changed to 0.11
    • Practice expense GPCI 0.881 changed to 0.886
    • Malpractice GPCI 0.782 changed to 0.798

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $284.58changed to$308.46

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.92 changed to 8.78

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $239.81changed to$284.58

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.17 changed to 7.92
    • Malpractice RVU 0.09 changed to 0.10
    • Practice expense GPCI 0.886 changed to 0.881
    • Malpractice GPCI 0.868 changed to 0.782

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $198.18changed to$239.81

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.83 changed to 6.17
    • Malpractice RVU 0.10 changed to 0.09
    • Practice expense GPCI 0.891 changed to 0.886
    • Malpractice GPCI 0.954 changed to 0.868

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $153.37changed to$198.18

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.44 changed to 4.83

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $151.28changed to$153.37

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.43 changed to 3.44
    • Practice expense GPCI 0.882 changed to 0.891
    • Malpractice GPCI 0.900 changed to 0.954

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $148.87changed to$151.28

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.41 changed to 3.43
    • Practice expense GPCI 0.872 changed to 0.882
    • Malpractice GPCI 0.845 changed to 0.900

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$148.87

    Held through RVU16B, RVU16C, RVU16D.

  13. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$278.36$56.15RVU26D
2026-07-01$278.36$56.15RVU26C
2026-04-01$278.36$56.15RVU26B
2026-01-01$278.36$56.15RVU26A
2025-10-01$271.01$60.62RVU25D
2025-07-01$271.01$60.62RVU25C
2025-04-01$271.01$60.62RVU25B
2025-01-01$271.01$60.62RVU25A
2024-10-01$286.33$61.51RVU24D
2024-07-01$286.33$61.51RVU24C
2024-04-01$286.33$61.51RVU24B
2024-03-09$286.33$61.51RVU24AR
2024-01-01$281.66$60.51RVU24A
2023-10-01$296.66$61.87RVU23D
2023-07-01$296.66$61.87RVU23C
2023-04-01$296.66$61.87RVU23B
2023-01-01$296.66$61.87RVU23A
2022-10-01$308.46$61.81RVU22D
2022-07-01$308.46$61.81RVU22C
2022-04-01$308.46$61.81RVU22B
2022-01-01$308.46$61.81RVU22A
2021-10-01$284.58$62.32RVU21D
2021-07-01$284.58$62.32RVU21C
2021-04-01$284.58$62.32RVU21B
2021-01-01$284.58$62.32RVU21A
2020-10-01$239.81$64.58RVU20D
2020-07-01$239.81$64.58RVU20C
2020-04-01$239.81$64.58RVU20B
2020-01-01$239.81$64.58RVU20A
2019-10-01$198.18$65.56RVU19D
2019-07-01$198.18$65.56RVU19C
2019-04-01$198.18$65.56RVU19B
2019-01-01$198.18$65.56RVU19A
2018-10-01$153.37$65.81RVU18D
2018-07-01$153.37$65.81RVU18C
2018-04-01$153.37$65.81RVU18B
2018-01-01$153.37$65.81RVU18AR1
2017-10-01$151.28$65.50RVU17D
2017-07-01$151.28$65.50RVU17C
2017-04-01$151.28$65.50RVU17B
2017-01-01$151.28$65.50RVU17A
2016-10-01$148.87$64.89RVU16D
2016-07-01$148.87$64.89RVU16C
2016-04-01$148.87$64.89RVU16B
2016-01-01$148.87$64.89RVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 50431 for an earlier date of service

Where the Oklahoma rate applies

Oklahoma is a Medicare payment area, not a city. Our Census mapping connects it to 846 cities and communities in Oklahoma. Some span more than one payment area; confirm with the service ZIP.

  • Lahoma
  • Achille
  • Ada
  • Adair
  • Adams
  • Adamson
  • Addington
  • Afton

Browse all communities in Oklahoma

50431 billing questions

How does 50431 differ from 50430?

50431 is for a contrast study reached through newly created percutaneous access. Use 50430 when the study uses existing access, such as an established nephrostomy catheter.

Can 50431 be reported with nephrostomy catheter placement?

The nephrostomy placement code includes the diagnostic nephrostogram or ureterogram when performed. Do not separately report 50431 for that included study.

Is imaging guidance or interpretation separately reported?

The code includes imaging guidance and the associated radiological interpretation for the contrast study.

How is bilateral service reported?

Report modifier 50 for bilateral service. CMS pays the bilateral procedure at 150%.

What documentation supports 50431?

Document why the study was needed, that access was newly obtained, the contrast examination and its findings, and the side or sides examined.

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
RVUs for 50431PPRRVU2026_Oct_nonQPP.csv, line 5,918 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)

Open CMS sourceHow we calculate rates

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