Billing code 50389: Nephrostomy removalMedicare rate & RVUs
Removal of a percutaneous nephrostomy catheter with fluoroscopic guidance is reported when a kidney drainage tube is no longer needed.
Medicare pays $396.13 for 50389 nationally in the office and $45.76 in a hospital or facility. Local office rates run $343.94–$555.73.
Medicare rate · 50389
Nephrostomy removal
Swap in your local Medicare rate.
- Work RVUs
- 1.07
- Total RVUs
- 11.86
- Global days
- 000
National rate · 2026
$396.13
Office setting, before claim adjustments.
See every locality for 50389 → · 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
What 50389 covers
This service removes an existing percutaneous nephrostomy catheter under fluoroscopic guidance, with radiological supervision and interpretation included. It is typically performed by an interventional radiologist or another appropriately trained physician in an imaging suite or hospital procedure room. The target is a catheter entering the renal collecting system to drain the kidney, rather than a ureteral stent or nephroureteral catheter.
Report the service when the nephrostomy catheter is removed and fluoroscopic guidance is used; documentation should identify the catheter and site, the removal, and the imaging guidance. Same-day preoperative and postoperative care is included in the 0-day global period. When bilateral removal is performed, modifier 50 is paid at 150%. For multiple procedures in the same session, CMS pays the highest-valued procedure in full and reduces the others to 50%. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing 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 50389 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$343.94 to $555.73
109 of 109 payment localities
50389 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.
$343.94
$492.42
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $435.37 | 1 |
| AL | $349.85 | 1 |
| AR | $343.94 | 1 |
| AZ | $384.51 | 1 |
| CA | $429.10–$555.73 | 29 |
| CO | $418.49 | 1 |
| CT | $425.13 | 1 |
| DC | $461.95 | 1 |
| DE | $391.63 | 1 |
| FL | $382.47–$416.87 | 3 |
| GA | $358.41–$402.75 | 2 |
| GU | $443.27 | 1 |
| HI | $443.27 | 1 |
| IA | $363.42 | 1 |
| ID | $365.51 | 1 |
| IL | $367.39–$409.10 | 4 |
| IN | $368.06 | 1 |
| KS | $359.93 | 1 |
| KY | $356.23 | 1 |
| LA | $354.98–$375.65 | 2 |
| MA | $414.78–$466.30 | 2 |
| MD | $400.44–$461.95 | 3 |
| ME | $366.11–$391.45 | 2 |
| MI | $365.65–$386.41 | 2 |
| MN | $403.65 | 1 |
| MO | $346.85–$379.04 | 3 |
| MS | $345.55 | 1 |
| MT | $396.13 | 1 |
| NC | $370.81 | 1 |
| ND | $393.75 | 1 |
| NE | $366.20 | 1 |
| NH | $410.25 | 1 |
| NJ | $430.74–$455.68 | 2 |
| NM | $367.36 | 1 |
| NV | $395.82 | 1 |
| NY | $377.12–$469.21 | 5 |
| OH | $365.16 | 1 |
| OK | $357.11 | 1 |
| OR | $393.52–$435.24 | 2 |
| PA | $366.69–$412.16 | 2 |
| PR | $399.99 | 1 |
| RI | $408.14 | 1 |
| SC | $368.45 | 1 |
| SD | $393.47 | 1 |
| TN | $361.85 | 1 |
| TX | $363.78–$416.42 | 8 |
| UT | $374.34 | 1 |
| VA | $388.90–$461.95 | 2 |
| VI | $399.99 | 1 |
| VT | $390.59 | 1 |
| WA | $414.53–$478.09 | 2 |
| WI | $378.39 | 1 |
| WV | $351.18 | 1 |
| WY | $395.09 | 1 |
How the 50389 rate is calculated
Each of 50389’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 · 50389
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.07Practice expense 10.67Malpractice 0.12
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 50389
The CMS indicators that decide how 50389 is paid alongside other services.
CMS payment indicators · 50389
Nephrostomy removal
| 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 | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| 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
50389 without 50 · national office
$396.13
Nephrostomy removal
50389-50 · Bilateral: 150%
$594.20
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).
50389 compared with similar codes
Compare codes
50389 vs 50384 vs 50386 vs 50387: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 50384Stent removal
- 50384 addresses percutaneous removal of a ureteral stent. Use 50389 for a nephrostomy catheter entering the renal collecting system.
- 50386Stent removal
- 50386 is for ureteral stent removal through the urethra. 50389 is for removal of a percutaneous nephrostomy catheter with fluoroscopic guidance.
- 50387Catheter exchange
- 50387 describes exchange of a nephroureteral catheter. 50389 describes removal of a nephrostomy catheter, not catheter exchange.
50389 billing questions
How does this differ from removing a ureteral stent?
Report 50389 for removal of a nephrostomy catheter that enters the kidney through the skin. Ureteral stent removal is selected according to whether the stent is removed percutaneously or through the urethra.
Is fluoroscopic imaging separately reported?
Radiological supervision and interpretation are included in this service. The documentation should support that fluoroscopic guidance was used for catheter removal.
Can modifier 50 be used for bilateral removal?
Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150% when removal is performed bilaterally.
How does the multiple procedure reduction affect payment?
When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the other procedures at 50%.
Can an assistant or co-surgeon be billed?
Assistant-at-surgery payment is restricted for this code. Co-surgeons and team surgery are not permitted.
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
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