Billing code 50432: Nephrostomy placementMedicare rate & RVUs
Reports creation of new percutaneous renal access and placement of a nephrostomy catheter to drain the collecting system, with imaging guidance included.
Medicare pays $864.08 for 50432 nationally in the office and $177.69 in a hospital or facility. Local office rates run $755.67–$1,189.75.
Medicare rate · 50432
Nephrostomy placement
Swap in your local Medicare rate.
- Work RVUs
- 3.9
- Total RVUs
- 25.87
- Global days
- 000
National rate · 2026
$864.08
Office setting, before claim adjustments.
See every locality for 50432 → · 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 50432 covers
An interventional radiologist or urologist creates a new percutaneous route into the kidney and places a nephrostomy catheter to drain urine externally. This is commonly performed when obstruction, such as from a ureteral stone or tumor, requires drainage. Ultrasound or fluoroscopy guidance and a diagnostic nephrostogram or ureterogram, when performed as part of the placement, are included in the service.
Report this code for catheter placement through new access, not for imaging of an existing nephrostomy tract or exchange of a catheter already in place. The record should support the need for drainage, the new access and catheter placement, and the imaging used. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When bilateral procedures are reported with modifier 50, CMS pays 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment is restricted; 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 50432 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
$755.67 to $1189.75
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $767.92 | $167.33 |
| Alaska* | $969.53 | $238.53 |
| Arizona | $839.71 | $174.60 |
| Arkansas | $755.67 | $166.06 |
| Atlanta | $878.87 | $181.50 |
| Austin | $904.43 | $178.23 |
| Bakersfield | $930.01 | $177.73 |
| Baltimore/Surr. Cntys | $922.09 | $185.59 |
| Beaumont | $798.31 | $173.70 |
| Brazoria | $855.49 | $175.28 |
| Chicago | $887.19 | $197.37 |
| Chico | $928.70 | $176.42 |
| Colorado | $908.54 | $178.23 |
| Connecticut | $925.10 | $185.86 |
| Dallas | $860.34 | $176.69 |
| Dc + Md/Va Suburbs | $1,000.80 | $192.24 |
| Delaware | $854.65 | $176.50 |
| Detroit | $848.75 | $186.39 |
| East St. Louis | $821.09 | $189.61 |
| El Centro | $928.77 | $176.49 |
| Fort Lauderdale | $885.04 | $189.73 |
| Fort Worth | $853.33 | $176.55 |
| Fresno | $928.70 | $176.42 |
| Galveston | $857.62 | $176.03 |
| Hanford-Corcoran | $928.70 | $176.42 |
| Hawaii, Guam | $956.60 | $176.18 |
| Houston | $865.49 | $183.90 |
| Idaho | $798.96 | $167.48 |
| Indiana | $804.18 | $167.90 |
| Iowa | $794.27 | $166.22 |
| Kansas | $787.89 | $167.39 |
| Kentucky | $783.00 | $172.80 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $996.26 | $184.26 |
| Madera | $928.70 | $176.42 |
| Manhattan | $997.39 | $199.80 |
| Merced | $928.70 | $176.42 |
| Metropolitan Boston | $1,007.42 | $187.87 |
| Metropolitan Kansas City | $819.86 | $175.35 |
| Metropolitan Philadelphia | $898.70 | $184.17 |
| Metropolitan St. Louis | $829.58 | $176.13 |
| Miami | $915.54 | $201.01 |
| Minnesota | $874.83 | $168.54 |
| Mississippi | $760.33 | $169.35 |
| Modesto | $928.70 | $176.42 |
| Montana** | $864.05 | $177.66 |
| Napa | $1,094.01 | $189.35 |
| Nebraska | $799.75 | $166.21 |
| Nevada** | $862.40 | $175.33 |
| New Hampshire | $891.78 | $177.25 |
| New Mexico | $807.25 | $177.84 |
| New Orleans | $823.59 | $177.70 |
| North Carolina | $810.69 | $170.29 |
| North Dakota** | $855.55 | $169.16 |
| Northern Nj | $988.38 | $192.17 |
| Nyc Suburbs/Long Island | $1,020.70 | $204.59 |
| Ohio | $801.60 | $174.93 |
| Oklahoma | $783.90 | $170.95 |
| Oxnard-Thousand Oaks-Ventura | $993.25 | $181.94 |
| Portland | $942.35 | $179.77 |
| Poughkpsie/N Nyc Suburbs | $941.31 | $189.71 |
| Puerto Rico | $871.78 | $177.84 |
| Queens | $1,009.71 | $198.40 |
| Redding | $928.70 | $176.42 |
| Rest Of California | $928.70 | $176.42 |
| Rest Of Florida | $839.65 | $183.46 |
| Rest Of Georgia | $789.14 | $176.88 |
| Rest Of Illinois | $809.57 | $182.90 |
| Rest Of Louisiana | $780.74 | $173.29 |
| Rest Of Maine | $801.10 | $169.62 |
| Rest Of Maryland | $872.84 | $178.21 |
| Rest Of Massachusetts | $901.38 | $178.61 |
| Rest Of Michigan | $803.34 | $176.67 |
| Rest Of Missouri | $764.42 | $172.76 |
| Rest Of New Jersey | $936.87 | $187.34 |
| Rest Of New York | $823.84 | $171.77 |
| Rest Of Oregon | $856.94 | $173.29 |
| Rest Of Pennsylvania | $804.30 | $174.19 |
| Rest Of Texas | $826.00 | $174.61 |
| Rest Of Washington | $900.47 | $177.71 |
| Rhode Island | $888.75 | $179.71 |
| Riverside-San Bernardino-Ontario | $933.38 | $181.10 |
| Sacramento-Roseville-Folsom | $979.38 | $181.11 |
| Salinas | $975.85 | $180.32 |
| San Diego-Chula Vista-Carlsbad | $1,002.42 | $181.50 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $1,163.66 | $195.86 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $1,163.17 | $195.37 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $1,189.75 | $199.97 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $1,187.75 | $197.98 |
| San Luis Obispo-Paso Robles | $959.64 | $177.84 |
| Santa Cruz-Watsonville | $1,014.84 | $180.87 |
| Santa Maria-Santa Barbara | $980.49 | $180.17 |
| Santa Rosa-Petaluma | $1,025.36 | $182.48 |
| Seattle (King Cnty) | $1,031.28 | $189.08 |
| South Carolina | $807.25 | $173.03 |
| South Dakota** | $854.54 | $168.16 |
| Southern Maine | $852.31 | $172.10 |
| Stockton | $928.70 | $176.42 |
| Suburban Chicago | $895.51 | $190.59 |
| Tennessee | $791.96 | $168.03 |
| Utah | $819.45 | $174.24 |
| Vallejo | $1,093.30 | $188.64 |
| Vermont | $849.79 | $170.27 |
| Virgin Islands | $871.78 | $177.84 |
| Virginia | $847.63 | $172.91 |
| Visalia | $928.70 | $176.42 |
| West Virginia | $776.02 | $179.55 |
| Wisconsin | $823.93 | $166.37 |
| Wyoming** | $860.35 | $173.96 |
| Yuba City | $928.70 | $176.42 |
50432 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$755.67
$1,059.23
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 | $969.53 | 1 |
| AL | $767.92 | 1 |
| AR | $755.67 | 1 |
| AZ | $839.71 | 1 |
| CA | $928.70–$1,189.75 | 29 |
| CO | $908.54 | 1 |
| CT | $925.10 | 1 |
| DC | $1,000.80 | 1 |
| DE | $854.65 | 1 |
| FL | $839.65–$915.54 | 3 |
| GA | $789.14–$878.87 | 2 |
| GU | $956.60 | 1 |
| HI | $956.60 | 1 |
| IA | $794.27 | 1 |
| ID | $798.96 | 1 |
| IL | $809.57–$895.51 | 4 |
| IN | $804.18 | 1 |
| KS | $787.89 | 1 |
| KY | $783.00 | 1 |
| LA | $780.74–$823.59 | 2 |
| MA | $901.38–$1,007.42 | 2 |
| MD | $872.84–$1,000.80 | 3 |
| ME | $801.10–$852.31 | 2 |
| MI | $803.34–$848.75 | 2 |
| MN | $874.83 | 1 |
| MO | $764.42–$829.58 | 3 |
| MS | $760.33 | 1 |
| MT | $864.05 | 1 |
| NC | $810.69 | 1 |
| ND | $855.55 | 1 |
| NE | $799.75 | 1 |
| NH | $891.78 | 1 |
| NJ | $936.87–$988.38 | 2 |
| NM | $807.25 | 1 |
| NV | $862.40 | 1 |
| NY | $823.84–$1,020.70 | 5 |
| OH | $801.60 | 1 |
| OK | $783.90 | 1 |
| OR | $856.94–$942.35 | 2 |
| PA | $804.30–$898.70 | 2 |
| PR | $871.78 | 1 |
| RI | $888.75 | 1 |
| SC | $807.25 | 1 |
| SD | $854.54 | 1 |
| TN | $791.96 | 1 |
| TX | $798.31–$904.43 | 8 |
| UT | $819.45 | 1 |
| VA | $847.63–$1,000.80 | 2 |
| VI | $871.78 | 1 |
| VT | $849.79 | 1 |
| WA | $900.47–$1,031.28 | 2 |
| WI | $823.93 | 1 |
| WV | $776.02 | 1 |
| WY | $860.35 | 1 |
How the 50432 rate is calculated
Each of 50432’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 · 50432
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.90Practice expense 21.54Malpractice 0.43
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 50432
The CMS indicators that decide how 50432 is paid alongside other services.
CMS payment indicators · 50432
Nephrostomy placement
| 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
50432 without 50 · national office
$864.08
Nephrostomy placement
50432-50 · Bilateral: 150%
$1,296.12
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).
50432 compared with similar codes
Compare codes
50432 vs 50433 vs 50431 vs 50435: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 50433Catheter placement
- Use 50432 for a nephrostomy catheter draining from the kidney. Use 50433 when the new catheter is advanced into the ureter as a nephroureteral catheter.
- 50431Antegrade contrast study
- 50431 reports an injection study using new access; 50432 reports catheter placement through new access, including diagnostic imaging performed as part of that placement.
- 50435Nephrostomy exchange
- 50435 is for exchanging a nephrostomy catheter already in place. 50432 is for placement through newly created percutaneous access.
50432 billing questions
How is this different from placement of a nephroureteral catheter?
50432 places a nephrostomy catheter for drainage from the kidney. Use 50433 when the catheter is placed through new access and extends into the ureter.
Can the nephrostogram be billed separately?
A diagnostic nephrostogram or ureterogram performed as part of the catheter placement is included, as are imaging guidance and associated radiological supervision and interpretation.
When is 50430 or 50431 more appropriate?
Those codes describe an injection study for nephrostography or ureterography without the catheter placement reported by 50432. Choose based on whether access is existing or newly created and whether a catheter is placed.
Can modifier 50 be used when both kidneys are treated?
CMS identifies this as a bilateral procedure; when reported with modifier 50, payment is 150%. Documentation should support placement on both sides.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50%. The 0-day global period includes same-day preoperative and postoperative care.
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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