CPT code 50432: Nephrostomy placement, new percutaneous access2026 Medicare rate & RVUs in Alabama
Reports creation of new percutaneous renal access and placement of a nephrostomy catheter to drain the collecting system, with imaging guidance included.
In Alabama, Medicare pays $767.92 for 50432 in the office and $167.33 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 50432 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 50432 covers
An interventional radiologist or urologist creates a new percutaneous route into the kidney and places a nephrostomy catheter to drain urine externally. This is commonly performed when obstruction, such as from a ureteral stone or tumor, requires drainage. Ultrasound or fluoroscopy guidance and a diagnostic nephrostogram or ureterogram, when performed as part of the placement, are included in the service.
Report this code for catheter placement through new access, not for imaging of an existing nephrostomy tract or exchange of a catheter already in place. The record should support the need for drainage, the new access and catheter placement, and the imaging used. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When bilateral procedures are reported with modifier 50, CMS pays 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery 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 Alabama compares for 50432
Across 109 of 109 payment localities, the office rate for 50432 runs from $755.67 in Arkansas to $1,189.75 in San Benito County, CA. Alabama pays $767.92. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Alabama · this page$767.92
- Los Angeles, CA · California$996.26+$228.34
- Washington, DC area · District of Columbia$1,000.80+$232.88
- Miami, FL · Florida$915.54+$147.62
- Chicago, IL · Illinois$887.19+$119.27
- Manhattan, NY · New York$997.39+$229.47
- Alaska · Alaska$969.53+$201.61
Other areas in Alabama first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $755.67 | $166.06 |
| ArizonaArizona | $839.71 | $174.60 |
| Bakersfield, CACalifornia | $930.01 | $177.73 |
| Chico, CACalifornia | $928.70 | $176.42 |
| El Centro, CACalifornia | $928.77 | $176.49 |
| Fresno, CACalifornia | $928.70 | $176.42 |
| Hanford, CACalifornia | $928.70 | $176.42 |
| Madera, CACalifornia | $928.70 | $176.42 |
| Merced, CACalifornia | $928.70 | $176.42 |
| Modesto, CACalifornia | $928.70 | $176.42 |
| Napa, CACalifornia | $1,094.01 | $189.35 |
| Oxnard, CACalifornia | $993.25 | $181.94 |
| Redding, CACalifornia | $928.70 | $176.42 |
| Rest of CaliforniaCalifornia | $928.70 | $176.42 |
| Riverside, CACalifornia | $933.38 | $181.10 |
| Sacramento, CACalifornia | $979.38 | $181.11 |
| Salinas, CACalifornia | $975.85 | $180.32 |
| San Diego, CACalifornia | $1,002.42 | $181.50 |
| Marin County, CACalifornia | $1,163.66 | $195.86 |
| San Francisco, CACalifornia | $1,163.17 | $195.37 |
| San Benito County, CACalifornia | $1,189.75 | $199.97 |
| Santa Clara County, CACalifornia | $1,187.75 | $197.98 |
| San Luis Obispo, CACalifornia | $959.64 | $177.84 |
| Santa Cruz, CACalifornia | $1,014.84 | $180.87 |
| Santa Maria, CACalifornia | $980.49 | $180.17 |
| Santa Rosa, CACalifornia | $1,025.36 | $182.48 |
| Stockton, CACalifornia | $928.70 | $176.42 |
| Vallejo, CACalifornia | $1,093.30 | $188.64 |
| Visalia, CACalifornia | $928.70 | $176.42 |
| Yuba City, CACalifornia | $928.70 | $176.42 |
| ColoradoColorado | $908.54 | $178.23 |
| ConnecticutConnecticut | $925.10 | $185.86 |
| DelawareDelaware | $854.65 | $176.50 |
| Fort Lauderdale, FLFlorida | $885.04 | $189.73 |
| Rest of FloridaFlorida | $839.65 | $183.46 |
| Atlanta, GAGeorgia | $878.87 | $181.50 |
| Rest of GeorgiaGeorgia | $789.14 | $176.88 |
| Hawaii, Guam, HIHawaii | $956.60 | $176.18 |
| IowaIowa | $794.27 | $166.22 |
| IdahoIdaho | $798.96 | $167.48 |
| East St. Louis, ILIllinois | $821.09 | $189.61 |
| Rest of IllinoisIllinois | $809.57 | $182.90 |
| Suburban Chicago, ILIllinois | $895.51 | $190.59 |
| IndianaIndiana | $804.18 | $167.90 |
| KansasKansas | $787.89 | $167.39 |
| KentuckyKentucky | $783.00 | $172.80 |
| New Orleans, LALouisiana | $823.59 | $177.70 |
| Rest of LouisianaLouisiana | $780.74 | $173.29 |
| Metropolitan Boston, MAMassachusetts | $1,007.42 | $187.87 |
| Rest of MassachusettsMassachusetts | $901.38 | $178.61 |
| Baltimore area, MDMaryland | $922.09 | $185.59 |
| Rest of MarylandMaryland | $872.84 | $178.21 |
| Rest of MaineMaine | $801.10 | $169.62 |
| Southern Maine, MEMaine | $852.31 | $172.10 |
| Detroit, MIMichigan | $848.75 | $186.39 |
| Rest of MichiganMichigan | $803.34 | $176.67 |
| MinnesotaMinnesota | $874.83 | $168.54 |
| Metropolitan Kansas City, MOMissouri | $819.86 | $175.35 |
| Metropolitan St. Louis, MOMissouri | $829.58 | $176.13 |
| Rest of MissouriMissouri | $764.42 | $172.76 |
| MississippiMississippi | $760.33 | $169.35 |
| MontanaMontana | $864.05 | $177.66 |
| North CarolinaNorth Carolina | $810.69 | $170.29 |
| North DakotaNorth Dakota | $855.55 | $169.16 |
| NebraskaNebraska | $799.75 | $166.21 |
| New HampshireNew Hampshire | $891.78 | $177.25 |
| Northern New JerseyNew Jersey | $988.38 | $192.17 |
| Rest of New JerseyNew Jersey | $936.87 | $187.34 |
| New MexicoNew Mexico | $807.25 | $177.84 |
| NevadaNevada | $862.40 | $175.33 |
| NYC suburbs and Long Island, NYNew York | $1,020.70 | $204.59 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $941.31 | $189.71 |
| Queens, NYNew York | $1,009.71 | $198.40 |
| Rest of New YorkNew York | $823.84 | $171.77 |
| OhioOhio | $801.60 | $174.93 |
| OklahomaOklahoma | $783.90 | $170.95 |
| Portland, OROregon | $942.35 | $179.77 |
| Rest of OregonOregon | $856.94 | $173.29 |
| Metropolitan Philadelphia, PAPennsylvania | $898.70 | $184.17 |
| Rest of PennsylvaniaPennsylvania | $804.30 | $174.19 |
| Puerto RicoPuerto Rico | $871.78 | $177.84 |
| Rhode IslandRhode Island | $888.75 | $179.71 |
| South CarolinaSouth Carolina | $807.25 | $173.03 |
| South DakotaSouth Dakota | $854.54 | $168.16 |
| TennesseeTennessee | $791.96 | $168.03 |
| Austin, TXTexas | $904.43 | $178.23 |
| Beaumont, TXTexas | $798.31 | $173.70 |
| Brazoria, TXTexas | $855.49 | $175.28 |
| Dallas, TXTexas | $860.34 | $176.69 |
| Fort Worth, TXTexas | $853.33 | $176.55 |
| Galveston, TXTexas | $857.62 | $176.03 |
| Houston, TXTexas | $865.49 | $183.90 |
| Rest of TexasTexas | $826.00 | $174.61 |
| UtahUtah | $819.45 | $174.24 |
| VirginiaVirginia | $847.63 | $172.91 |
| Virgin Islands, VIUnited States Virgin Islands | $871.78 | $177.84 |
| VermontVermont | $849.79 | $170.27 |
| Rest of WashingtonWashington | $900.47 | $177.71 |
| King County, WAWashington | $1,031.28 | $189.08 |
| WisconsinWisconsin | $823.93 | $166.37 |
| West VirginiaWest Virginia | $776.02 | $179.55 |
| WyomingWyoming | $860.35 | $173.96 |
50432 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$755.67
$1,059.23
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $969.53 | 1 |
| AL | $767.92 | 1 |
| AR | $755.67 | 1 |
| AZ | $839.71 | 1 |
| CA | $928.70–$1,189.75 | 29 |
| CO | $908.54 | 1 |
| CT | $925.10 | 1 |
| DC | $1,000.80 | 1 |
| DE | $854.65 | 1 |
| FL | $839.65–$915.54 | 3 |
| GA | $789.14–$878.87 | 2 |
| GU | $956.60 | 1 |
| HI | $956.60 | 1 |
| IA | $794.27 | 1 |
| ID | $798.96 | 1 |
| IL | $809.57–$895.51 | 4 |
| IN | $804.18 | 1 |
| KS | $787.89 | 1 |
| KY | $783.00 | 1 |
| LA | $780.74–$823.59 | 2 |
| MA | $901.38–$1,007.42 | 2 |
| MD | $872.84–$1,000.80 | 3 |
| ME | $801.10–$852.31 | 2 |
| MI | $803.34–$848.75 | 2 |
| MN | $874.83 | 1 |
| MO | $764.42–$829.58 | 3 |
| MS | $760.33 | 1 |
| MT | $864.05 | 1 |
| NC | $810.69 | 1 |
| ND | $855.55 | 1 |
| NE | $799.75 | 1 |
| NH | $891.78 | 1 |
| NJ | $936.87–$988.38 | 2 |
| NM | $807.25 | 1 |
| NV | $862.40 | 1 |
| NY | $823.84–$1,020.70 | 5 |
| OH | $801.60 | 1 |
| OK | $783.90 | 1 |
| OR | $856.94–$942.35 | 2 |
| PA | $804.30–$898.70 | 2 |
| PR | $871.78 | 1 |
| RI | $888.75 | 1 |
| SC | $807.25 | 1 |
| SD | $854.54 | 1 |
| TN | $791.96 | 1 |
| TX | $798.31–$904.43 | 8 |
| UT | $819.45 | 1 |
| VA | $847.63–$1,000.80 | 2 |
| VI | $871.78 | 1 |
| VT | $849.79 | 1 |
| WA | $900.47–$1,031.28 | 2 |
| WI | $823.93 | 1 |
| WV | $776.02 | 1 |
| WY | $860.35 | 1 |
How the 50432 rate is calculated
Each of 50432’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 · 50432
RVUs × geographic indexes × conversion factor
Work3.90
3.90 RVUs× 1.000 GPCI
Practice expense21.54
21.54 RVUs× 1.000 GPCI
Malpractice0.43
0.43 RVUs× 1.000 GPCI
Adjusted RVUs
25.8700
Conversion factor
$33.4009
Medicare rate
$864.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Alabama inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,919
- Code
- 50432
- Physician work
- 3.90
- Practice expense
- 21.54
- Malpractice
- 0.43
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.90 | × 1.000 | 3.9000 |
| Practice expense | 21.54 | × 0.875 | 18.8475 |
| Malpractice | 0.43 | × 0.566 | 0.2434 |
| Total RVUs | 22.9909 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Alabama$767.92
Office: (3.9 × 1 + 21.54 × 0.875 + 0.43 × 0.566) × $33.4009 = $767.92
Facility: (3.9 × 1 + 0.99 × 0.875 + 0.43 × 0.566) × $33.4009 = $167.33
Payment rules and modifiers for 50432
The CMS indicators that decide how 50432 is paid alongside other services.
CMS payment indicators · 50432
Nephrostomy placement, new percutaneous access
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
50432 without 50 · national office
$864.08
Nephrostomy placement, new percutaneous access
50432-50 · Bilateral: 150%
$1,296.12
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).
How 50432 has changed in Alabama
50432 · Office / nonfacility
$767.92
Effective 2026-10-01
The base rate is $21.41 higher than on 2025-10-01, moving from $746.51 to $767.92 (2.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$746.51changed to$767.92
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 4.00 changed to 3.90
- Practice expense RVU 21.69 changed to 21.54
- Malpractice RVU 0.40 changed to 0.43
- Practice expense GPCI 0.869 changed to 0.875
- Malpractice GPCI 0.575 changed to 0.566
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$786.74changed to$746.51
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 22.33 changed to 21.69
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$773.90changed to$786.74
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$831.20changed to$773.90
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 23.04 changed to 22.33
- Practice expense GPCI 0.878 changed to 0.869
- Malpractice GPCI 0.748 changed to 0.575
January 1, 2023
RVU23A
$876.66changed to$831.20
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 23.66 changed to 23.04
- Malpractice RVU 0.35 changed to 0.40
- Practice expense GPCI 0.888 changed to 0.878
- Malpractice GPCI 0.921 changed to 0.748
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$875.24changed to$876.66
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 23.39 changed to 23.66
- Malpractice RVU 0.34 changed to 0.35
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$825.44changed to$875.24
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 20.95 changed to 23.39
- Malpractice RVU 0.35 changed to 0.34
- Practice expense GPCI 0.889 changed to 0.888
- Malpractice GPCI 0.707 changed to 0.921
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$765.24changed to$825.44
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 19.17 changed to 20.95
- Practice expense GPCI 0.890 changed to 0.889
- Malpractice GPCI 0.492 changed to 0.707
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$714.56changed to$765.24
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 17.62 changed to 19.17
- Malpractice RVU 0.34 changed to 0.35
Held through RVU19B, RVU19C, RVU19D.
April 1, 2018
RVU18B
No ratechanged to$714.56
Held through RVU18C, RVU18D.
January 1, 2016
RVU16A
No ratechanged toNo rate
Held through RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $767.92 | $167.33 | RVU26D |
| 2026-07-01 | $767.92 | $167.33 | RVU26C |
| 2026-04-01 | $767.92 | $167.33 | RVU26B |
| 2026-01-01 | $767.92 | $167.33 | RVU26A |
| 2025-10-01 | $746.51 | $182.08 | RVU25D |
| 2025-07-01 | $746.51 | $182.08 | RVU25C |
| 2025-04-01 | $746.51 | $182.08 | RVU25B |
| 2025-01-01 | $746.51 | $182.08 | RVU25A |
| 2024-10-01 | $786.74 | $185.93 | RVU24D |
| 2024-07-01 | $786.74 | $185.93 | RVU24C |
| 2024-04-01 | $786.74 | $185.93 | RVU24B |
| 2024-03-09 | $786.74 | $185.93 | RVU24AR |
| 2024-01-01 | $773.90 | $182.90 | RVU24A |
| 2023-10-01 | $831.20 | $192.70 | RVU23D |
| 2023-07-01 | $831.20 | $192.70 | RVU23C |
| 2023-04-01 | $831.20 | $192.70 | RVU23B |
| 2023-01-01 | $831.20 | $192.70 | RVU23A |
| 2022-10-01 | $876.66 | $197.52 | RVU22D |
| 2022-07-01 | $876.66 | $197.52 | RVU22C |
| 2022-04-01 | $876.66 | $197.52 | RVU22B |
| 2022-01-01 | $876.66 | $197.52 | RVU22A |
| 2021-10-01 | $875.24 | $199.15 | RVU21D |
| 2021-07-01 | $875.24 | $199.15 | RVU21C |
| 2021-04-01 | $875.24 | $199.15 | RVU21B |
| 2021-01-01 | $875.24 | $199.15 | RVU21A |
| 2020-10-01 | $825.44 | $204.94 | RVU20D |
| 2020-07-01 | $825.44 | $204.94 | RVU20C |
| 2020-04-01 | $825.44 | $204.94 | RVU20B |
| 2020-01-01 | $825.44 | $204.94 | RVU20A |
| 2019-10-01 | $765.24 | $202.64 | RVU19D |
| 2019-07-01 | $765.24 | $202.64 | RVU19C |
| 2019-04-01 | $765.24 | $202.64 | RVU19B |
| 2019-01-01 | $765.24 | $202.64 | RVU19A |
| 2018-10-01 | $714.56 | $202.89 | RVU18D |
| 2018-07-01 | $714.56 | $202.89 | RVU18C |
| 2018-04-01 | $714.56 | $202.89 | RVU18B |
| 2018-01-01 | Rate data unavailable | Rate data unavailable | RVU18AR1 |
| 2017-10-01 | Rate data unavailable | Rate data unavailable | RVU17D |
| 2017-07-01 | Rate data unavailable | Rate data unavailable | RVU17C |
| 2017-04-01 | Rate data unavailable | Rate data unavailable | RVU17B |
| 2017-01-01 | Rate data unavailable | Rate data unavailable | RVU17A |
| 2016-10-01 | Rate data unavailable | Rate data unavailable | RVU16D |
| 2016-07-01 | Rate data unavailable | Rate data unavailable | RVU16C |
| 2016-04-01 | Rate data unavailable | Rate data unavailable | RVU16B |
| 2016-01-01 | Rate data unavailable | Rate data unavailable | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Alabama rate applies
Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.
- Abanda
- Abbeville
- Adamsville
- Addison
- Akron
- Alabaster
- Albertville
- Alexander City
50432 billing questions
How is this different from placement of a nephroureteral catheter?
50432 places a nephrostomy catheter for drainage from the kidney. Use 50433 when the catheter is placed through new access and extends into the ureter.
Can the nephrostogram be billed separately?
A diagnostic nephrostogram or ureterogram performed as part of the catheter placement is included, as are imaging guidance and associated radiological supervision and interpretation.
When is 50430 or 50431 more appropriate?
Those codes describe an injection study for nephrostography or ureterography without the catheter placement reported by 50432. Choose based on whether access is existing or newly created and whether a catheter is placed.
Can modifier 50 be used when both kidneys are treated?
CMS identifies this as a bilateral procedure; when reported with modifier 50, payment is 150%. Documentation should support placement on both sides.
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 others at 50%. The 0-day global period includes same-day preoperative and postoperative care.
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
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