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Billing code 50065: Kidney stone surgeryMedicare rate & RVUs

Reports a secondary open operation to remove a kidney stone when the documented surgical circumstances distinguish it from routine initial stone removal.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,078.18 for 50065 nationally in a facility.

Medicare rate · 50065

Kidney stone surgery

Swap in your local Medicare rate.

Work RVUs
21.76
Total RVUs
32.28
Global days
090

National rate · 2026

$1,078.18

Facility setting, before claim adjustments.

See every locality for 50065 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 50065 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 50065 covers

A urologist uses this code for a secondary open operation to remove a calculus from the kidney. The procedure involves surgically reaching the kidney and treating the stone through an open approach, typically in a hospital operating room. The code distinguishes this service from routine open stone removal and from percutaneous procedures that reach the kidney through a small access tract.

Choose the code based on the operative circumstances, not stone size alone; the record should describe the calculus, the open approach, and why the operation is secondary. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. For bilateral surgery reported with modifier 50, payment is at 150%. Assistant-at-surgery payment may be made; 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 50065 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

50065 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,005.46
Alaska*Unavailable$1,416.52
ArizonaUnavailable$1,056.76
ArkansasUnavailable$996.58
AtlantaUnavailable$1,103.22
AustinUnavailable$1,083.99
BakersfieldUnavailable$1,080.34
Baltimore/Surr. CntysUnavailable$1,130.74
BeaumontUnavailable$1,048.33
BrazoriaUnavailable$1,061.17

50065 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
50065 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 50065 rate is calculated

Each of 50065’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 · 50065

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 21.76Practice expense 7.73Malpractice 2.79

32.2800 adjusted RVUs×$33.4009 conversion factor=$1,078.18

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 50065

50065 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 50065

Kidney stone surgery

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.08/0.83/0.09Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 50065

Kidney stone surgery

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

50065 without 50 · national facility

$1,078.18

Kidney stone surgery

50065-50 · Bilateral: 150%

$1,617.27

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

50065 compared with similar codes

Compare codes

50065 vs 50060 vs 50075 vs 50080 vs 50081: national Medicare rates

Swap in your local Medicare rate.

  • 50065
    Kidney stone surgery · 21.76 wRVU
    —
  • 50060
    Kidney stone surgery · 20.43 wRVU
    —
  • 50075
    Kidney stone removal · 26.41 wRVU
    —
  • 50080
    Percutaneous stone removal · 12.1 wRVU
    —
  • 50081
    Kidney stone removal · 20.39 wRVU
    —

How to choose

50060Kidney stone surgery
50060 describes routine open renal calculus removal. Report 50065 when the documented operative circumstances support a secondary operation.
50075Kidney stone removal
50075 identifies open removal of a large staghorn calculus. Do not select 50065 based on stone size when the large-staghorn service applies.
50080Percutaneous stone removal
50080 is a percutaneous stone-treatment service for stones up to 2 cm; 50065 describes a secondary open operation.
50081Kidney stone removal
50081 is the percutaneous code for larger or more complex stone treatment. The operative approach distinguishes it from 50065.

Codes related to 50065

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

Codes related to 50065
CodeHow it relatesNational office range
Same family
50060Kidney stone surgeryRoutine open renal calculus removal, rather than a secondary operation.No office rate
50070NephrectomyOpen renal calculus surgery complicated by congenital kidney abnormality.No office rate
50075Kidney stone removalOpen removal of a large staghorn calculus.No office rate
Used instead
50080Percutaneous stone removalPercutaneous treatment for a renal or pelvic stone up to 2 cm.No office rate
50081Kidney stone removalPercutaneous treatment for a renal or pelvic stone over 2 cm or with greater complexity.No office rate

50065 billing questions

How does this differ from 50060?

50065 is for a secondary open operation for a renal calculus. Use 50060 for routine open removal when the circumstances do not support reporting a secondary operation.

Does stone size determine whether to report 50065?

No. The selection turns on the secondary-operation circumstances, not stone size alone. A large staghorn calculus has a distinct open procedure code, 50075.

Can the kidney incision and stone extraction be billed separately?

The access to the kidney and treatment of the calculus are part of the open stone operation; do not separately report those operative steps as distinct services.

How is bilateral surgery paid?

When the procedure is performed bilaterally and reported with modifier 50, CMS pays at 150%.

What documentation supports reporting 50065?

Document the kidney and calculus treated, the open approach, and the operative circumstances supporting classification as a secondary operation. The operative report should make the distinction from routine stone removal clear.

Can an assistant surgeon be reported?

Assistant-at-surgery payment may be made for this code. Co-surgeons and team surgery are not permitted under the CMS rules provided.

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 50065PPRRVU2026_Oct_nonQPP.csv, line 5,871 (RVU26D)

Open CMS sourceHow we calculate rates

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