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

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 Wisconsin, Medicare pays $416.34 for 50955 in the office and $287.38 when it’s performed in a hospital or facility.

$416.34Office (non-facility)
$287.38Hospital or facility
−6.3%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 Wisconsin
  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 Wisconsin 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. Wisconsin pays $416.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

50955 in Wisconsin vs other payment areas
  1. Wisconsin · this page$416.34
  2. Los Angeles, CA · California$479.63+$63.29
  3. Washington, DC area · District of Columbia$494.25+$77.91
  4. Miami, FL · Florida$495.69+$79.35
  5. Chicago, IL · Illinois$483.52+$67.18
  6. Manhattan, NY · New York$506.73+$90.39
  7. Alaska · Alaska$553.97+$137.63

Other areas in Wisconsin 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.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Wisconsin 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

111

Locality
Wisconsin
Physician work
1.000
Practice expense
0.958
Malpractice
0.308
Office calculation for 50955 in Wisconsin
ComponentRVULocality factorAdjusted
Physician work6.57× 1.0006.5700
Practice expense5.88× 0.9585.6330
Malpractice0.85× 0.3080.2618
Total RVUs12.4648
Conversion factor× 33.4009

Office rate, Wisconsin$416.34

Office: (6.57 × 1 + 5.88 × 0.958 + 0.85 × 0.308) × $33.4009 = $416.34

Facility: (6.57 × 1 + 1.85 × 0.958 + 0.85 × 0.308) × $33.4009 = $287.38

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

Codes related to 50955

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 50955
CodeHow it relatesOffice range, Wisconsin
Same family
50951Ureteroscopy, diagnostic examinationDiagnostic ureteroscopy without the biopsy service described here.$368.95
50957Ureteroscopy, endoscopic lesion treatmentRelated ureteroscopic treatment code; distinguish treatment from tissue sampling.$420.23
50961Ureteroscopy, endoscopic treatmentAnother ureteroscopic treatment code in the same general endoscopy family.$379.90
50974Ureteroscopy, biopsy during ureteroscopyA related ureteroscopic biopsy code; compare the full service details before selecting.No office rate

How 50955 has changed in Wisconsin

50955 · Office / nonfacility

$416.34

Effective 2026-10-01

The base rate is $23.93 higher than on 2025-10-01, moving from $392.41 to $416.34 (6.1%).

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

    $392.41changed to$416.34

    • 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 0.957 changed to 0.958
    • Malpractice GPCI 0.331 changed to 0.308

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $399.68changed to$392.41

    • 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

    $393.16changed to$399.68

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $400.35changed to$393.16

    • 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 0.950 changed to 0.957
    • Malpractice GPCI 0.314 changed to 0.331

  5. January 1, 2023

    RVU23A

    $404.01changed to$400.35

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.99 changed to 5.08
    • Practice expense GPCI 0.942 changed to 0.950
    • Malpractice GPCI 0.296 changed to 0.314

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $408.03changed to$404.01

    • 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

    $415.33changed to$408.03

    • 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 0.949 changed to 0.942
    • Malpractice GPCI 0.322 changed to 0.296

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $418.40changed to$415.33

    • 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 0.957 changed to 0.949
    • Malpractice GPCI 0.347 changed to 0.322

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $418.97changed to$418.40

    • 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

    $417.34changed to$418.97

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.76 changed to 4.85
    • Practice expense GPCI 0.956 changed to 0.957
    • Malpractice GPCI 0.457 changed to 0.347

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $416.54changed to$417.34

    • 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 0.955 changed to 0.956
    • Malpractice GPCI 0.566 changed to 0.457

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $417.56changed to$416.54

    • 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

    $415.49changed to$417.56

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $411.68changed to$415.49

    • 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 0.958 changed to 0.955
    • Malpractice GPCI 0.557 changed to 0.566

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $401.46changed to$411.68

    • 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 0.960 changed to 0.958
    • Malpractice GPCI 0.547 changed to 0.557

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$401.46

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$416.34$287.38RVU26D
2026-07-01$416.34$287.38RVU26C
2026-04-01$416.34$287.38RVU26B
2026-01-01$416.34$287.38RVU26A
2025-10-01$392.41$316.26RVU25D
2025-07-01$392.41$316.26RVU25C
2025-04-01$392.41$316.26RVU25B
2025-01-01$392.41$316.26RVU25A
2024-10-01$399.68$323.23RVU24D
2024-07-01$399.68$323.23RVU24C
2024-04-01$399.68$323.23RVU24B
2024-03-09$399.68$323.23RVU24AR
2024-01-01$393.16$317.95RVU24A
2023-10-01$400.35$325.01RVU23D
2023-07-01$400.35$325.01RVU23C
2023-04-01$400.35$325.01RVU23B
2023-01-01$400.35$325.01RVU23A
2022-10-01$404.01$328.05RVU22D
2022-07-01$404.01$328.05RVU22C
2022-04-01$404.01$328.05RVU22B
2022-01-01$404.01$328.05RVU22A
2021-10-01$408.03$331.12RVU21D
2021-07-01$408.03$331.12RVU21C
2021-04-01$408.03$331.12RVU21B
2021-01-01$408.03$331.12RVU21A
2020-10-01$415.33$343.41RVU20D
2020-07-01$415.33$343.41RVU20C
2020-04-01$415.33$343.41RVU20B
2020-01-01$415.33$343.41RVU20A
2019-10-01$418.40$345.97RVU19D
2019-07-01$418.40$345.97RVU19C
2019-04-01$418.40$345.97RVU19B
2019-01-01$418.40$345.97RVU19A
2018-10-01$418.97$346.97RVU18D
2018-07-01$418.97$346.97RVU18C
2018-04-01$418.97$346.97RVU18B
2018-01-01$418.97$346.97RVU18AR1
2017-10-01$417.34$347.69RVU17D
2017-07-01$417.34$347.69RVU17C
2017-04-01$417.34$347.69RVU17B
2017-01-01$417.34$347.69RVU17A
2016-10-01$416.54$347.82RVU16D
2016-07-01$416.54$347.82RVU16C
2016-04-01$416.54$347.82RVU16B
2016-01-01$416.54$347.82RVU16A
2015-10-01$417.56$349.27RVU15D
2015-07-01$417.56$349.27RVU15C
2015-04-01$415.49$347.54RVU15B
2015-01-01$415.49$347.54RVU15A
2014-10-01$411.68$345.45RVU14D
2014-07-01$411.68$345.45RVU14C
2014-04-01$411.68$345.45RVU14B
2014-01-01$411.68$345.45RVU14A
2013-10-01$401.46$344.62RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 50955 for an earlier date of service

Where the Wisconsin rate applies

Wisconsin is a Medicare payment area, not a city. Our Census mapping connects it to 807 cities and communities in Wisconsin. Some span more than one payment area; confirm with the service ZIP.

  • Abbotsford
  • Abrams
  • Adams
  • Adell
  • Albany
  • Algoma
  • Allens Grove
  • Allenton

Browse all communities in Wisconsin

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 WisconsinGPCI2026.csv, line 111 (RVU26D)

Open CMS sourceHow we calculate rates

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