CPT code 50820: Urinary diversion, continent intestinal reservoir2026 Medicare rate & RVUs in Massachusetts
Reports urinary diversion with a continent intestinal reservoir, such as an Indiana pouch, generally created with cystectomy and ureteral implantation.
CMS doesn’t publish an office rate for 50820 in Massachusetts.
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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On this page 9 sections
What 50820 covers
A urologist constructs a reservoir from bowel to store urine and connects the ureters to it, with a continent outlet that can be emptied by catheterization. An Indiana pouch is a familiar example. The operation is commonly performed in a hospital for patients needing urinary diversion, including after bladder removal for cancer. The service includes cystectomy as part of the diversion when performed; the operative report should identify the reservoir and its continent method of emptying.
Choose this code for a continent intestinal reservoir, not an ileal conduit or sigmoid bladder diversion. Documentation should describe the bowel reservoir, ureteral connections, outlet, and whether cystectomy was performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 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 allowed; 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 50820 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | $1,254.45 |
| Rest of Massachusetts | Unavailable | $1,184.40 |
How the 50820 rate is calculated
Each of 50820’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 · 50820
RVUs × geographic indexes × conversion factor
Work23.47
23.47 RVUs× 1.000 GPCI
Practice expense8.57
8.57 RVUs× 1.000 GPCI
Malpractice3.25
3.25 RVUs× 1.000 GPCI
Adjusted RVUs
35.2900
Conversion factor
$33.4009
Medicare rate
$1,178.72
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 50820
50820 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50820
Urinary diversion, continent intestinal reservoir
| 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 · 50820
Urinary diversion, continent intestinal reservoir
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
50820 without 50 · national facility
$1,178.72
Urinary diversion, continent intestinal reservoir
50820-50 · Bilateral: 150%
$1,768.08
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).
50820 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 50825Urinary diversionContinent bowel reservoir
- Use 50820 for a continent intestinal reservoir. Use 50825 for diversion through an ileal conduit or sigmoid bladder.
- 50815Urinary diversionUreterosigmoidostomy
- 50815 describes urinary diversion with ureterosigmoidostomy; 50820 describes a continent intestinal reservoir, such as an Indiana pouch.
- 50810Ureter-bowel connectionUreteral fusion
- 50810 is for ureterosigmoidostomy with creation of a sigmoid bladder and bilateral ureteral implantation, not a continent catheterized intestinal reservoir.
50820 billing questions
How does this differ from 50825?
50820 is for a continent intestinal reservoir, such as an Indiana pouch. 50825 describes a diversion using an ileal conduit or sigmoid bladder.
Is cystectomy included?
Cystectomy is included in the urinary-diversion service when performed as part of the operation. The operative report should establish the diversion and whether the bladder was removed.
Can bowel reconstruction steps be billed separately?
Do not separately report steps integral to creating the same reservoir and urinary diversion. The record should make clear that the reconstruction is a continent intestinal reservoir.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
How are multiple procedures and bilateral reporting handled?
For multiple procedures 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%.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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