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Billing code 50120: PyelotomyMedicare rate & RVUs

Reports an open incision into the renal pelvis for surgical exploration when the documented procedure does not include the separately defined work of calculus removal or pyelostomy drainage.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $853.39 for 50120 nationally in a facility.

Medicare rate · 50120

Pyelotomy

Swap in your local Medicare rate.

Work RVUs
16.78
Total RVUs
25.55
Global days
090

National rate · 2026

$853.39

Facility setting, before claim adjustments.

See every locality for 50120 → · 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 50120 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 50120 covers

A urologist opens the renal pelvis to inspect the collecting system directly. The operation may be performed when surgical access and exploration of the pelvis are needed, but the operative report does not describe the specific additional work represented by pyelostomy drainage or calculus removal. This is an operative service, generally performed in a hospital or other surgical facility.

Report 50120 when the documented procedure is pyelotomy with exploration. The operative report should identify the renal pelvis incision and the exploration performed; use the more specific code when the procedure includes drainage through a pyelostomy or removal of a calculus. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery 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 50120 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

50120 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$794.48
Alaska*Unavailable$1,115.58
ArizonaUnavailable$836.16
ArkansasUnavailable$787.27
AtlantaUnavailable$873.11
AustinUnavailable$859.09
BakersfieldUnavailable$857.03
Baltimore/Surr. CntysUnavailable$895.58
BeaumontUnavailable$828.40
BrazoriaUnavailable$840.02

50120 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
50120 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 50120 rate is calculated

Each of 50120’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 · 50120

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.78Practice expense 6.61Malpractice 2.16

25.5500 adjusted RVUs×$33.4009 conversion factor=$853.39

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

Payment rules and modifiers for 50120

50120 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 50120

Pyelotomy

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 · 50120

Pyelotomy

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

50120 without 50 · national facility

$853.39

Pyelotomy

50120-50 · Bilateral: 150%

$1,280.09

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

50120 compared with similar codes

Compare codes

50120 vs 50125 vs 50130: national Medicare rates

Swap in your local Medicare rate.

  • 50120
    Pyelotomy · 16.78 wRVU
    —
  • 50125
    Pyelotomy · 17.37 wRVU
    —
  • 50130
    Stone removal · 18.35 wRVU
    —

How to choose

50125Pyelotomy
Choose 50125 when the pyelotomy includes drainage through a pyelostomy. 50120 describes exploration without that specified drainage procedure.
50130Stone removal
Choose 50130 when a calculus is removed through the pyelotomy. 50120 describes exploration without the specified calculus-removal work.

Codes related to 50120

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

Codes related to 50120
CodeHow it relatesNational office range
Same family
50125PyelotomyPyelotomy with drainage through a pyelostomy rather than exploration alone.No office rate
50130Stone removalPyelotomy that includes removal of a calculus.No office rate

50120 billing questions

When should 50120 be chosen over 50130?

Use 50120 for pyelotomy with exploration. When the surgeon removes a calculus through the pyelotomy, 50130 describes that more specific procedure.

How does 50120 differ from 50125?

50125 describes pyelotomy with drainage through a pyelostomy. Report 50120 when the documented work is exploration rather than that drainage procedure.

What should the operative report document?

It should establish that the surgeon incised the renal pelvis and explored it. It should also clarify whether the procedure included calculus removal, pyelostomy drainage, or reconstructive work.

How is bilateral 50120 reported?

For a bilateral procedure, report 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 is not permitted.

What payment rules affect other procedures performed in the same session?

Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and the other procedures at 50%.

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 50120PPRRVU2026_Oct_nonQPP.csv, line 5,878 (RVU26D)

Open CMS sourceHow we calculate rates

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