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Billing code 50081: Kidney stone removalMedicare rate & RVUs

Percutaneous nephrolithotomy for renal or pelvic stones larger than 2 cm, reported when the surgeon fragments and removes stones through a kidney access tract.

CMS RVU26DEffective Oct 1, 2026109 payment localities12.2K Medicare services in 2024

Medicare pays $1,001.69 for 50081 nationally in a facility.

Medicare rate · 50081

Kidney stone removal

Work RVUs
20.39
Total RVUs
29.99
Global days
090

National rate · 2026

$1,001.69

Facility setting, before claim adjustments.

See every locality for 50081 →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 50081 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 50081 covers

A urologist uses an access tract through the flank to reach the kidney or renal pelvis, then fragments and removes a stone burden larger than 2 cm. The operation is typically performed in an operating room, often for large or complex renal stones that require percutaneous rather than ureteroscopic treatment. The procedure may involve nephroscopic inspection and stone extraction as well as lithotripsy.

Select this code when the documented stone size exceeds 2 cm; code 50080 is the related choice for stones up to 2 cm. The operative report should establish stone size, location, laterality, the percutaneous approach, and the fragmentation or removal performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 identifies bilateral surgery and is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team-surgery billing is 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 50081 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

50081 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$934.67
Alaska*Unavailable$1,318.25
ArizonaUnavailable$981.90
ArkansasUnavailable$926.49
AtlantaUnavailable$1,024.99
AustinUnavailable$1,006.66
BakersfieldUnavailable$1,002.96
Baltimore/Surr. CntysUnavailable$1,050.29
BeaumontUnavailable$974.49
BrazoriaUnavailable$985.86

50081 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
50081 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 50081 rate is calculated

Each of 50081’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 · 50081

RVUs × geographic indexes × conversion factor

Work20.39

20.39 RVUs× 1.000 GPCI

Practice expense6.99

6.99 RVUs× 1.000 GPCI

Malpractice2.61

2.61 RVUs× 1.000 GPCI

Adjusted RVUs

29.9900

Conversion factor

$33.4009

Medicare rate

$1,001.69

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

Payment rules and modifiers for 50081

50081 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 50081

Kidney stone removal

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)1Permitted with supporting documentation.
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 · 50081

Kidney stone removal

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

50081 without 50 · national facility

$1,001.69

Kidney stone removal

50081-50 · Bilateral: 150%

$1,502.54

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

50081 compared with similar codes

Compare codes · National

5 codes, side by side

  • 50081

    Kidney stone removal20.39 wRVU

    Not priced

  • 50080

    Percutaneous stone removal12.1 wRVU

    Not priced

  • 50075

    Kidney stone removal26.41 wRVU

    Not priced

  • 50060

    Kidney stone surgery20.43 wRVU

    Not priced

  • 52356

    Ureteroscopic lithotripsy7.8 wRVU

    Not priced

How to choose

50080Percutaneous stone removal
Both describe percutaneous kidney stone treatment; 50081 is for stones larger than 2 cm, while 50080 is for stones up to 2 cm.
50075Kidney stone removal
50075 describes open removal of a large staghorn calculus; 50081 uses a percutaneous access tract for stones larger than 2 cm.
50060Kidney stone surgery
50060 is nephrolithotomy for calculus removal by an open approach. Choose 50081 when the surgeon treats a stone larger than 2 cm percutaneously.
52356Ureteroscopic lithotripsy
52356 treats stones through ureteroscopy or pyeloscopy and includes lithotripsy with ureteral stent insertion; 50081 uses percutaneous access to the kidney.

Codes related to 50081

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

Codes related to 50081
CodeHow it relatesNational office range
Same family
50080Percutaneous stone removalPercutaneous kidney stone treatment for stones up to 2 cm.No office rate
Used instead
50075Kidney stone removalOpen nephrolithotomy for removal of a large staghorn calculus.No office rate
50060Kidney stone surgeryNephrolithotomy for calculus removal by an open approach.No office rate
52356Ureteroscopic lithotripsyUreteroscopic or pyeloscopic stone treatment with lithotripsy and ureteral stent insertion.No office rate

50081 billing questions

When should 50081 be chosen over 50080?

Use 50081 for a stone burden larger than 2 cm treated by the percutaneous approach. Code 50080 is the related code for stones up to 2 cm.

What documentation supports 50081?

Document stone size, kidney or renal-pelvis location, laterality, the percutaneous approach, and the fragmentation or removal performed.

How does the 90-day global period affect billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

How is bilateral surgery reported?

Report bilateral surgery with modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team-surgery billing is not permitted.

How are other procedures in the same session paid?

CMS pays the highest-valued procedure in full and other procedures at 50% when multiple procedures are performed in the same session.

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 50081PPRRVU2026_Oct_nonQPP.csv, line 5,875 (RVU26D)

Open CMS sourceHow we calculate rates

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