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Billing code 50400: PyeloplastyMedicare rate & RVUs

Reports open reconstruction of the renal pelvis or ureteropelvic junction for a simple repair, commonly to relieve an obstruction impairing kidney drainage.

CMS RVU26DEffective Oct 1, 2026109 payment localities51 Medicare services in 2024

Medicare pays $1,033.09 for 50400 nationally in a facility.

Medicare rate · 50400

Pyeloplasty

Swap in your local Medicare rate.

Work RVUs
20.74
Total RVUs
30.93
Global days
090

National rate · 2026

$1,033.09

Facility setting, before claim adjustments.

See every locality for 50400 → · 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 50400 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 50400 covers

A urologist uses this code for a simple open pyeloplasty, reconstructing the renal pelvis or ureteropelvic junction (UPJ), with or without an incision into the renal pelvis. A typical clinical indication is UPJ obstruction causing impaired drainage or hydronephrosis. The service is performed in an operating room; laparoscopic pyeloplasty is represented by a different code. The operative report should establish the repair performed and support selection of the simple rather than complicated pyeloplasty code.

Report 50400 for the simple repair, not the complicated repair represented by 50405. The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, CMS pays 150%. An assistant at surgery 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 50400 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

50400 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$962.99
Alaska*Unavailable$1,355.74
ArizonaUnavailable$1,012.46
ArkansasUnavailable$954.42
AtlantaUnavailable$1,057.11
AustinUnavailable$1,038.88
BakersfieldUnavailable$1,035.50
Baltimore/Surr. CntysUnavailable$1,083.65
BeaumontUnavailable$1,004.15
BrazoriaUnavailable$1,016.75

50400 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
50400 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 50400 rate is calculated

Each of 50400’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 · 50400

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 20.74Practice expense 7.52Malpractice 2.67

30.9300 adjusted RVUs×$33.4009 conversion factor=$1,033.09

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

Payment rules and modifiers for 50400

50400 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 50400

Pyeloplasty

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 · 50400

Pyeloplasty

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

50400 without 50 · national facility

$1,033.09

Pyeloplasty

50400-50 · Bilateral: 150%

$1,549.64

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

50400 compared with similar codes

Compare codes

50400 vs 50405 vs 50544 vs 50700: national Medicare rates

Swap in your local Medicare rate.

  • 50400
    Pyeloplasty · 20.74 wRVU
    —
  • 50405
    Pyeloplasty · 25.21 wRVU
    —
  • 50544
    Pyeloplasty · 22.79 wRVU
    —
  • 50700
    Ureter repair · 16.27 wRVU
    —

How to choose

50405Pyeloplasty
Both describe pyeloplasty, but 50400 is for a simple repair and 50405 for a complicated repair. Base the choice on the documented operative work.
50544Pyeloplasty
50544 describes laparoscopic pyeloplasty. Use 50400 for the simple open repair.
50700Ureter repair
50700 is ureteroplasty for reconstruction of the ureter; 50400 reconstructs the renal pelvis or UPJ.

Codes related to 50400

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

Codes related to 50400
CodeHow it relatesNational office range
Same family
50405PyeloplastyComplicated pyeloplasty; select it when the documented repair meets that level.No office rate
Used instead
50544PyeloplastyLaparoscopic pyeloplasty for the same general reconstructive need using a different approach.No office rate
50700Ureter repairUreteroplasty addresses reconstruction of the ureter rather than the renal pelvis or UPJ.No office rate

50400 billing questions

How do I choose between 50400 and 50405?

Use 50400 for a simple pyeloplasty and 50405 for a complicated one. The operative report should support the selected level; the diagnosis alone does not establish complexity.

Is laparoscopic pyeloplasty reported with 50400?

No. billing code 50544 represents laparoscopic surgical pyeloplasty; 50400 is the simple open pyeloplasty code.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

How are additional procedures in the same session paid?

CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How is a bilateral pyeloplasty reported?

CMS identifies this as a bilateral procedure; with modifier 50, payment is at 150%.

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 50400PPRRVU2026_Oct_nonQPP.csv, line 5,915 (RVU26D)

Open CMS sourceHow we calculate rates

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