CPT code 50953: Ureteroscopy, with ureteral catheterization2026 Medicare rate & RVUs in Illinois
Reports ureteroscopic examination through a ureterostomy with ureteral catheterization, including associated irrigation, instillation, or ureteropyelography when performed.
Medicare pays $415.67–$453.71 for 50953 in the office in Illinois, from Rest of Illinois to Chicago, IL. Which amount applies depends on the service address.
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 50953 covers
A urologist passes an endoscope through an existing ureterostomy to examine the ureter and catheterize it. Irrigation, instillation, or ureteropyelography may accompany the procedure. This approach is distinct from reaching the ureter through the bladder and urethra; it uses the surgically created opening from the ureter to the body surface. It may be performed in a facility setting for evaluation or management of a ureteral problem when this access route is used.
Report the code when the documented service includes ureteroscopy through the ureterostomy and ureteral catheterization; the operative note should identify the access route and services performed. CMS applies endoscopy-family pricing when related endoscopies are performed together, so those services are not necessarily paid as separate full procedures. The 0-day global period includes same-day preoperative and postoperative care. For a bilateral procedure, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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.
Where 50953 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$415.67 to $453.71
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $453.71 | $323.46 |
| East St. Louis, IL | $428.89 | $309.66 |
| Rest of Illinois | $415.67 | $297.35 |
| Suburban Chicago, IL | $444.04 | $310.95 |
How the 50953 rate is calculated
Each of 50953’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 · 50953
RVUs × geographic indexes × conversion factor
Work6.07
6.07 RVUs× 1.000 GPCI
Practice expense5.63
5.63 RVUs× 1.000 GPCI
Malpractice0.79
0.79 RVUs× 1.000 GPCI
Adjusted RVUs
12.4900
Conversion factor
$33.4009
Medicare rate
$417.18
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 50953
The CMS indicators that decide how 50953 is paid alongside other services.
CMS payment indicators · 50953
Ureteroscopy, with ureteral catheterization
| 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 | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| 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
50953 without 50 · national office
$417.18
Ureteroscopy, with ureteral catheterization
50953-50 · Bilateral: 150%
$625.77
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).
50953 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 50951UreteroscopyDiagnostic examination
- Both use ureterostomy access, but 50951 describes diagnostic ureteroscopy without the catheterization service included in 50953.
- 50955UreteroscopyWith biopsy
- Use 50955 when ureteroscopic biopsy is performed through the ureterostomy; 50953 is for catheterization with ureteroscopic access.
- 52351UreteroscopyDiagnostic examination only
- 52351 describes diagnostic ureteroscopy reached through the urethra and bladder. This code uses an existing ureterostomy and includes ureteral catheterization.
- 52352UreteroscopyStone removal or manipulation
- 52352 is used for transurethral ureteroscopy with calculus removal. It represents a different access route and a stone-removal service.
50953 billing questions
How does this differ from diagnostic ureteroscopy code 50951?
This code includes ureteral catheterization along with endoscopic access through a ureterostomy. Use 50951 when the documented service is diagnostic ureteroscopy through that route without the catheterization service.
When should a biopsy code be used instead?
Choose the applicable biopsy code, such as 50955, when the procedure includes taking a ureteral tissue sample. This code describes catheterization with ureteroscopic access, not biopsy.
Can related ureter endoscopies be separately paid when performed together?
CMS applies endoscopy-family pricing when related endoscopies are performed together. The payment treatment follows that family pricing rather than assuming each related endoscopy receives separate full payment.
What should the operative note establish?
Document that the endoscope entered through a ureterostomy, that the ureter was catheterized, and any associated irrigation, instillation, or ureteropyelography performed.
How is a bilateral procedure reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are 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
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