CPT code 50955: Ureteroscopy, with biopsy2026 Medicare rate & RVUs in Indiana

Reports endoscopic examination of the ureter with tissue sampling, such as biopsy of a suspicious ureteral lesion during a facility-based procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality30 Medicare services in 2024

In Indiana, Medicare pays $415.30 for 50955 in the office and $290.52 when it’s performed in a hospital or facility.

$415.30Office (non-facility)
$290.52Hospital or facility
−6.5%vs the national office rate ($444.23)

Check a contract rate as a % of Medicare · 50955 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 50955 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Indiana
  2. What 50955 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 50955 covers

A urologist passes an endoscope into the ureter to inspect its lining and obtain tissue from a finding that needs pathologic evaluation. A typical clinical situation is sampling a suspicious upper-tract urothelial lesion. The service is commonly performed in a hospital or ambulatory surgery setting; Medicare recorded facility services for this code in 2024.

Report the code when the documented ureteroscopic service includes biopsy, and support it with the indication, ureter and side examined, endoscopic findings, and tissue-sampling details. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy family pricing applies. For bilateral procedures, modifier 50 is paid at 150%. An assistant at surgery is paid only when medical necessity is documented; 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 Indiana compares for 50955

Across 109 of 109 payment localities, the office rate for 50955 runs from $402.77 in Arkansas to $553.97 in Alaska. Indiana pays $415.30. The RVUs are the same everywhere; the geographic indexes change the dollars.

50955 in Indiana vs other payment areas
  1. Indiana · this page$415.30
  2. Los Angeles, CA · California$479.63+$64.33
  3. Washington, DC area · District of Columbia$494.25+$78.95
  4. Miami, FL · Florida$495.69+$80.39
  5. Chicago, IL · Illinois$483.52+$68.22
  6. Manhattan, NY · New York$506.73+$91.43
  7. Alaska · Alaska$553.97+$138.67

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

Every other payment area

50955 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$407.36$289.58
ArkansasArkansas$402.77$287.14
ArizonaArizona$434.06$303.62
Bakersfield, CACalifornia$456.15$308.63
Chico, CACalifornia$453.64$306.12
El Centro, CACalifornia$453.79$306.26
Fresno, CACalifornia$453.64$306.12
Hanford, CACalifornia$453.64$306.12

50955 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.

$402.77

$553.97

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

View every state and territory as a table
50955 office rate range by state
State / territoryOffice rate rangeLocalities
AK$553.971
AL$407.361
AR$402.771
AZ$434.061
CA$453.64–$542.0129
CO$453.221
CT$469.711
DC$494.251
DE$440.101
FL$449.87–$495.693
GA$428.47–$453.742
GU$459.191
HI$459.191
IA$410.421
ID$413.561
IL$443.13–$483.524
IN$415.301
KS$411.301
KY$420.021
LA$420.45–$436.512
MA$452.39–$488.212
MD$446.46–$494.253
ME$417.79–$431.992
MI$430.81–$456.832
MN$429.941
MO$416.39–$434.863
MS$409.521
MT$444.181
NC$420.821
ND$427.371
NE$411.451
NH$448.741
NJ$473.83–$491.412
NM$433.641
NV$439.691
NY$425.98–$519.735
OH$427.371
OK$416.891
OR$435.01–$462.282
PA$426.57–$461.712
PR$445.971
RI$451.821
SC$425.051
SD$425.381
TN$413.211
TX$424.54–$455.298
UT$429.551
VA$432.55–$494.252
VI$445.971
VT$428.241
WA$450.71–$494.592
WI$416.341
WV$430.741
WY$436.851

See 50955 in every payment locality

How the 50955 rate is calculated

Each of 50955’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 · 50955

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.57

6.57 RVUs× 1.000 GPCI

Practice expense5.88

5.88 RVUs× 1.000 GPCI

Malpractice0.85

0.85 RVUs× 1.000 GPCI

Adjusted RVUs

13.3000

Conversion factor

$33.4009

Medicare rate

$444.23

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

The exact Indiana inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,007

Code
50955
Physician work
6.57
Practice expense
5.88
Malpractice
0.85

GPCI2026.csv

52

Locality
Indiana
Physician work
1.000
Practice expense
0.927
Malpractice
0.486
Office calculation for 50955 in Indiana
ComponentRVULocality factorAdjusted
Physician work6.57× 1.0006.5700
Practice expense5.88× 0.9275.4508
Malpractice0.85× 0.4860.4131
Total RVUs12.4339
Conversion factor× 33.4009

Office rate, Indiana$415.30

Office: (6.57 × 1 + 5.88 × 0.927 + 0.85 × 0.486) × $33.4009 = $415.30

Facility: (6.57 × 1 + 1.85 × 0.927 + 0.85 × 0.486) × $33.4009 = $290.52

Open 50955 in the RVU calculator

Payment rules and modifiers for 50955

The CMS indicators that decide how 50955 is paid alongside other services.

CMS payment indicators · 50955

Ureteroscopy, with biopsy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
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

50955 without 50 · national office

$444.23

Ureteroscopy, with biopsy

50955-50 · Bilateral: 150%

$666.35

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 50955 has changed in Indiana

50955 · Office / nonfacility

$415.30

Effective 2026-10-01

The base rate is $24.86 higher than on 2025-10-01, moving from $390.44 to $415.30 (6.4%).

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

    $390.44changed to$415.30

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.74 changed to 6.57
    • Practice expense RVU 5.35 changed to 5.88
    • Malpractice RVU 0.82 changed to 0.85
    • Practice expense GPCI 0.922 changed to 0.927
    • Malpractice GPCI 0.485 changed to 0.486

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $397.80changed to$390.44

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.22 changed to 5.35

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $391.31changed to$397.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $397.94changed to$391.31

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.08 changed to 5.22
    • Malpractice RVU 0.79 changed to 0.82
    • Practice expense GPCI 0.911 changed to 0.922
    • Malpractice GPCI 0.475 changed to 0.485
  5. January 1, 2023

    RVU23A

    $401.37changed to$397.94

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.99 changed to 5.08
    • Practice expense GPCI 0.900 changed to 0.911
    • Malpractice GPCI 0.465 changed to 0.475

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $405.16changed to$401.37

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.02 changed to 4.99
    • Malpractice RVU 0.76 changed to 0.79

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $411.45changed to$405.16

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.76 changed to 5.02
    • Malpractice RVU 0.78 changed to 0.76
    • Practice expense GPCI 0.910 changed to 0.900
    • Malpractice GPCI 0.422 changed to 0.465

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $412.65changed to$411.45

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.82 changed to 4.76
    • Malpractice RVU 0.74 changed to 0.78
    • Practice expense GPCI 0.919 changed to 0.910
    • Malpractice GPCI 0.379 changed to 0.422

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $413.19changed to$412.65

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.85 changed to 4.82

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $412.28changed to$413.19

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.76 changed to 4.85
    • Practice expense GPCI 0.920 changed to 0.919
    • Malpractice GPCI 0.498 changed to 0.379

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $412.22changed to$412.28

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.68 changed to 4.76
    • Malpractice RVU 0.75 changed to 0.74
    • Practice expense GPCI 0.921 changed to 0.920
    • Malpractice GPCI 0.617 changed to 0.498

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $413.26changed to$412.22

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.66 changed to 4.68
    • Malpractice RVU 0.76 changed to 0.75

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $411.21changed to$413.26

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $407.04changed to$411.21

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.60 changed to 4.66
    • Malpractice RVU 0.62 changed to 0.76
    • Practice expense GPCI 0.922 changed to 0.921
    • Malpractice GPCI 0.615 changed to 0.617

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $396.75changed to$407.04

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.90 changed to 4.60
    • Malpractice RVU 0.65 changed to 0.62
    • Practice expense GPCI 0.923 changed to 0.922
    • Malpractice GPCI 0.613 changed to 0.615

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $396.75

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$415.30$290.52RVU26D
2026-07-01$415.30$290.52RVU26C
2026-04-01$415.30$290.52RVU26B
2026-01-01$415.30$290.52RVU26A
2025-10-01$390.44$317.07RVU25D
2025-07-01$390.44$317.07RVU25C
2025-04-01$390.44$317.07RVU25B
2025-01-01$390.44$317.07RVU25A
2024-10-01$397.80$324.15RVU24D
2024-07-01$397.80$324.15RVU24C
2024-04-01$397.80$324.15RVU24B
2024-03-09$397.80$324.15RVU24AR
2024-01-01$391.31$318.85RVU24A
2023-10-01$397.94$325.70RVU23D
2023-07-01$397.94$325.70RVU23C
2023-04-01$397.94$325.70RVU23B
2023-01-01$397.94$325.70RVU23A
2022-10-01$401.37$328.81RVU22D
2022-07-01$401.37$328.81RVU22C
2022-04-01$401.37$328.81RVU22B
2022-01-01$401.37$328.81RVU22A
2021-10-01$405.16$331.67RVU21D
2021-07-01$405.16$331.67RVU21C
2021-04-01$405.16$331.67RVU21B
2021-01-01$405.16$331.67RVU21A
2020-10-01$411.45$342.48RVU20D
2020-07-01$411.45$342.48RVU20C
2020-04-01$411.45$342.48RVU20B
2020-01-01$411.45$342.48RVU20A
2019-10-01$412.65$343.10RVU19D
2019-07-01$412.65$343.10RVU19C
2019-04-01$412.65$343.10RVU19B
2019-01-01$412.65$343.10RVU19A
2018-10-01$413.19$344.04RVU18D
2018-07-01$413.19$344.04RVU18C
2018-04-01$413.19$344.04RVU18B
2018-01-01$413.19$344.04RVU18AR1
2017-10-01$412.28$345.25RVU17D
2017-07-01$412.28$345.25RVU17C
2017-04-01$412.28$345.25RVU17B
2017-01-01$412.28$345.25RVU17A
2016-10-01$412.22$345.93RVU16D
2016-07-01$412.22$345.93RVU16C
2016-04-01$412.22$345.93RVU16B
2016-01-01$412.22$345.93RVU16A
2015-10-01$413.26$347.40RVU15D
2015-07-01$413.26$347.40RVU15C
2015-04-01$411.21$345.68RVU15B
2015-01-01$411.21$345.68RVU15A
2014-10-01$407.04$343.29RVU14D
2014-07-01$407.04$343.29RVU14C
2014-04-01$407.04$343.29RVU14B
2014-01-01$407.04$343.29RVU14A
2013-10-01$396.75$342.11RVU13D
2013-07-01$396.75$342.11RVU13C
2013-04-01$396.75$342.11RVU13B
2013-01-01$396.75$342.11RVU13AR

Price 50955 for an earlier date of service

Where the Indiana rate applies

Indiana is a Medicare payment area, not a city. Our Census mapping connects it to 974 cities and communities in Indiana. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Abington
  • Adams
  • Adams Lake
  • Advance
  • Akron
  • Alamo
  • Albany

Browse all communities in Indiana

50955 billing questions

When should this code be selected instead of diagnostic ureteroscopy?

Use this code when the ureteroscopic service includes biopsy. A diagnostic-only examination without tissue sampling is represented by a diagnostic ureteroscopy code, such as 50951.

Can the biopsy be reported separately from the ureteroscopy?

This code describes ureteroscopy with biopsy. The record should show the endoscopic examination and tissue sampling; do not treat the biopsy as an unrelated service merely because a specimen is sent to pathology.

How does CMS handle related endoscopies performed together?

Endoscopy family pricing applies when related endoscopies are performed together. The code’s payment is subject to that family pricing in the combined service.

How is a bilateral procedure reported?

For a bilateral procedure, report modifier 50; CMS pays the procedure at 150%. Document the ureteral work on both sides.

What assistant or co-surgeon rules apply?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

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 50955PPRRVU2026_Oct_nonQPP.csv, line 6,007 (RVU26D)
Geographic factors for IndianaGPCI2026.csv, line 52 (RVU26D)

Open CMS sourceHow we calculate rates

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