CPT code 50961: Ureteroscopy, endoscopic treatment2026 Medicare rate & RVUs in New York
Reports endoscopic treatment performed within the ureter using a ureteroscope, rather than diagnostic inspection or biopsy alone.
Medicare pays $388.46–$474.09 for 50961 in the office in New York, from Rest of New York to NYC suburbs and Long Island, NY. 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 50961 covers
A urologist advances a ureteroscope through the urinary tract to treat a problem within the ureter. The service is performed endoscopically, commonly in a hospital or ambulatory surgical setting. Code 50961 is distinguished by treatment during ureteral endoscopy; the particular intervention documented must support this code rather than a diagnostic-only or biopsy service.
Report the code when the operative note identifies the ureteroscopic treatment performed and the treated side. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. For bilateral treatment, 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.
Where 50961 pays more and less in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
5 payment localities
$388.46 to $474.09
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | $462.27 | $315.95 |
| NYC suburbs and Long Island, NY | $474.09 | $324.37 |
| Poughkeepsie and northern NYC suburbs, NY | $436.73 | $298.84 |
| Queens, NY | $462.28 | $313.44 |
| Rest of New York | $388.46 | $268.84 |
How the 50961 rate is calculated
Each of 50961’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 · 50961
RVUs × geographic indexes × conversion factor
Work5.89
5.89 RVUs× 1.000 GPCI
Practice expense5.48
5.48 RVUs× 1.000 GPCI
Malpractice0.76
0.76 RVUs× 1.000 GPCI
Adjusted RVUs
12.1300
Conversion factor
$33.4009
Medicare rate
$405.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 50961
The CMS indicators that decide how 50961 is paid alongside other services.
CMS payment indicators · 50961
Ureteroscopy, endoscopic treatment
| 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
50961 without 50 · national office
$405.15
Ureteroscopy, endoscopic treatment
50961-50 · Bilateral: 150%
$607.73
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).
50961 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 50951UreteroscopyDiagnostic examination
- 50951 is for diagnostic ureter endoscopy; 50961 is for endoscopy with treatment.
- 50955UreteroscopyWith biopsy
- 50955 identifies ureteroscopic biopsy. Report 50961 when the documented service is treatment rather than biopsy alone.
- 50957UreteroscopyEndoscopic lesion treatment
- Both are ureter endoscopy and treatment codes. Select the code whose full CPT description matches the specific procedure documented.
50961 billing questions
How does 50961 differ from diagnostic ureteroscopy?
50961 describes treatment during ureteral endoscopy. Use a diagnostic endoscopy code when the service is inspection rather than treatment.
Is biopsy alone reported with 50961?
No. The nearby biopsy code 50955 identifies ureteral endoscopy with biopsy; documentation should support the service actually performed.
What is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
How is bilateral treatment reported?
Modifier 50 applies to a bilateral procedure and is paid at 150%.
Can an assistant or co-surgeon be billed?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
What happens when related endoscopies are performed together?
CMS endoscopy family pricing applies when related endoscopies are performed together.
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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