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Billing code 50390: Renal lesion drainageMedicare rate & RVUs

Percutaneous needle drainage or injection of a renal cyst or renal pelvis is reported when the clinician treats or evaluates a kidney lesion.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.2K Medicare services in 2024

Medicare pays $80.83 for 50390 nationally in a facility.

Medicare rate · 50390

Renal lesion drainage

Swap in your local Medicare rate.

Work RVUs
1.91
Total RVUs
2.42
Global days
000

National rate · 2026

$80.83

Facility setting, before claim adjustments.

See every locality for 50390 → · 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 50390 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 50390 covers

A clinician uses a needle through the skin to aspirate fluid from, or inject material into, a renal cyst or the renal pelvis. The service may be performed by a urologist or interventional radiologist in a procedure room, imaging suite, or hospital setting. A typical clinical reason is evaluating or relieving symptoms from a fluid-filled renal cyst; the target and purpose of the procedure determine whether this code fits.

Report the service for the percutaneous needle procedure, with documentation identifying the renal target, approach, and work performed. This code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and reduces the others. For bilateral reporting with modifier 50, Medicare pays 150%. Medicare does not pay an assistant at surgery for this procedure; 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 50390 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

50390 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$76.53
Alaska*Unavailable$110.23
ArizonaUnavailable$79.51
ArkansasUnavailable$76.02
AtlantaUnavailable$82.59
AustinUnavailable$80.74
BakersfieldUnavailable$80.26
Baltimore/Surr. CntysUnavailable$84.24
BeaumontUnavailable$79.43
BrazoriaUnavailable$79.71

50390 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
50390 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 50390 rate is calculated

Each of 50390’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 · 50390

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.91Practice expense 0.30Malpractice 0.21

2.4200 adjusted RVUs×$33.4009 conversion factor=$80.83

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

Payment rules and modifiers for 50390

The CMS indicators that decide how 50390 is paid alongside other services.

CMS payment indicators · 50390

Renal lesion drainage

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

50390 without 50 · national facility

$80.83

Renal lesion drainage

50390-50 · Bilateral: 150%

$121.25

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

50390 compared with similar codes

Compare codes

50390 vs 50391 vs 50396: national Medicare rates

Swap in your local Medicare rate.

  • 50390
    Renal lesion drainage · 1.91 wRVU
    —
  • 50391
    Renal instillation · 1.91 wRVU
    $127.26
  • 50396
    Kidney pressure test · 2.04 wRVU
    —

How to choose

50391Renal instillation
50391 is for instilling a therapeutic agent into a renal cyst or pelvis. 50390 describes needle aspiration or injection of the renal target.
50396Kidney pressure test
50396 measures pressure in the renal pelvis. Choose 50390 when the documented service is needle aspiration or injection, not pressure measurement.

Codes related to 50390

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

Codes related to 50390
CodeHow it relatesNational office range
Used instead
50391Renal instillationUse for therapeutic-agent instillation into a renal cyst or pelvis rather than the aspiration or injection service described by 50390.$115.55–$159.16

50390 billing questions

How does 50390 differ from 50391?

50390 describes needle aspiration or injection involving a renal cyst or pelvis. Use 50391 when the documented service is instillation of a therapeutic agent into the renal target.

Does 50390 include same-day preoperative and postoperative care?

Yes. Its 0-day global period includes preoperative and postoperative care on the procedure date.

How is bilateral 50390 reported?

Report modifier 50 for a bilateral procedure. Medicare pays the bilateral service at 150% under the CMS rule provided.

What happens when another procedure is performed in the same session?

Medicare pays the highest-valued procedure in full and reduces the other procedure or procedures to 50% under the standard multiple procedure rule.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 50390. Co-surgeons and team surgery are not permitted under the CMS rules provided.

What documentation supports reporting 50390?

Document the renal cyst or pelvis treated, the percutaneous needle approach, and whether aspiration or injection was performed. The record should identify the procedure's clinical purpose.

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 50390PPRRVU2026_Oct_nonQPP.csv, line 5,912 (RVU26D)

Open CMS sourceHow we calculate rates

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