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Billing code 50365: Kidney transplantMedicare rate & RVUs

Reports transplantation of a donor kidney when the recipient's native kidney is also removed as part of the transplant operation.

CMS RVU26DEffective Oct 1, 2026109 payment localities102 Medicare services in 2024

Medicare pays $2,799.66 for 50365 nationally in a facility.

Medicare rate · 50365

Kidney transplant

Swap in your local Medicare rate.

Work RVUs
44.98
Total RVUs
83.82
Global days
090

National rate · 2026

$2,799.66

Facility setting, before claim adjustments.

See every locality for 50365 → · 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 50365 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 50365 covers

A transplant surgeon uses this code for a donor kidney implanted in a recipient when a recipient nephrectomy is performed as part of the same transplant operation. The service is generally performed in a hospital operating room. The recipient nephrectomy is included in this transplant service; it is not a separate nephrectomy performed independently of the transplant.

Choose this code instead of 50360 when the transplant operation includes removal of the recipient's kidney; 50360 describes the transplant without recipient nephrectomy. The operative report should support the transplant and the recipient nephrectomy performed during that operation. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 pays this bilateral procedure at 150%. Assistant-at-surgery payment, co-surgeons, and team surgery are 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 50365 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

50365 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,513.03
Alaska*Unavailable$3,428.13
ArizonaUnavailable$2,713.93
ArkansasUnavailable$2,478.18
AtlantaUnavailable$2,899.45
AustinUnavailable$2,808.63
BakersfieldUnavailable$2,756.58
Baltimore/Surr. CntysUnavailable$2,984.47
BeaumontUnavailable$2,690.56
BrazoriaUnavailable$2,715.01

50365 rates by state

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

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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.

View every state and territory as a table
50365 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 50365 rate is calculated

Each of 50365’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 · 50365

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 44.98Practice expense 26.78Malpractice 12.06

83.8200 adjusted RVUs×$33.4009 conversion factor=$2,799.66

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

Payment rules and modifiers for 50365

50365 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 50365

Kidney transplant

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)2Permitted.
Team surgery (66)2Permitted.
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 · 50365

Kidney transplant

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

50365 without 50 · national facility

$2,799.66

Kidney transplant

50365-50 · Bilateral: 150%

$4,199.49

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

50365 compared with similar codes

Compare codes

50365 vs 50360 vs 50340 vs 50370 vs 50380: national Medicare rates

Swap in your local Medicare rate.

  • 50365
    Kidney transplant · 44.98 wRVU
    —
  • 50360
    Kidney transplant · 38.88 wRVU
    —
  • 50340
    Recipient nephrectomy · 13.69 wRVU
    —
  • 50370
    Allograft removal · 18.41 wRVU
    —
  • 50380
    Kidney transplant · 29.36 wRVU
    —

How to choose

50360Kidney transplant
Both describe kidney allotransplantation, but 50365 includes recipient nephrectomy during the transplant operation; 50360 is for transplantation without it.
50340Recipient nephrectomy
50340 describes recipient nephrectomy as a separate service. When nephrectomy is performed as part of kidney allotransplantation, use 50365 instead.
50370Allograft removal
50370 describes removal of a previously transplanted renal allograft, not implantation of a donor kidney with recipient nephrectomy.
50380Kidney transplant
50380 describes autotransplantation of the patient's own kidney; 50365 is for transplantation of a donor kidney.

Codes related to 50365

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

Codes related to 50365
CodeHow it relatesNational office range
Same family
50360Kidney transplantKidney allotransplantation without recipient nephrectomy.No office rate
Often billed with
50323Prep cadaver renal allograftBackbench preparation of a cadaver donor renal allograft may accompany the transplant.No office rate
50325Prep donor renal graftBackbench preparation of a donor renal graft may accompany the transplant.No office rate
Used instead
50340Recipient nephrectomyRecipient nephrectomy without the combined transplant service.No office rate

50365 billing questions

How does this differ from 50360?

Use 50365 when recipient nephrectomy is performed as part of the kidney transplant. Use 50360 for the transplant without recipient nephrectomy.

Can the recipient nephrectomy be reported separately?

The recipient nephrectomy is included when performed as part of the transplant reported with 50365. Document it in the operative report as part of the transplant operation.

What does the 90-day global period include?

CMS includes the day-before preoperative visit and 90 days of related postoperative care in the global period for 50365.

How is modifier 50 handled?

CMS pays 50365 with modifier 50 at 150% for a bilateral procedure. The operative documentation should support the bilateral service.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made for 50365, and CMS permits co-surgeons and team surgery.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and the other procedures at 50% when 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 50365PPRRVU2026_Oct_nonQPP.csv, line 5,903 (RVU26D)

Open CMS sourceHow we calculate rates

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