Billing code 50434: Catheter conversionMedicare rate & RVUs
Reports percutaneous conversion of an existing nephrostomy catheter into a nephroureteral catheter, carrying the catheter through the ureter toward the bladder.
Medicare pays $865.08 for 50434 nationally in the office and $166.67 in a hospital or facility. Local office rates run $755.63–$1,194.46.
Medicare rate · 50434
Catheter conversion
Swap in your local Medicare rate.
- Work RVUs
- 3.66
- Total RVUs
- 25.90
- Global days
- 000
National rate · 2026
$865.08
Office setting, before claim adjustments.
See every locality for 50434 → · 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 50434 covers
An interventional radiologist or other qualified physician uses an existing percutaneous kidney access to redirect a nephrostomy catheter through the ureter, typically positioning its distal end in the bladder. This changes the drainage route from a catheter confined to the kidney to one that traverses the ureter. Fluoroscopic or other imaging guidance and a contrast study of the collecting system or ureter may be part of the procedure.
Report 50434 when an existing nephrostomy catheter is converted; documentation should identify the prior access and catheter, the route established, and the final catheter position. Imaging guidance, associated radiological supervision and interpretation, and a nephrostogram or ureterogram when performed are included. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued is paid in full and other procedures at 50%. For bilateral conversion, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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 50434 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
$755.63 to $1194.46
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $768.00 | $156.89 |
| Alaska* | $967.45 | $223.64 |
| Arizona | $840.51 | $163.75 |
| Arkansas | $755.63 | $155.70 |
| Atlanta | $879.87 | $170.28 |
| Austin | $906.06 | $167.14 |
| Bakersfield | $932.05 | $166.59 |
| Baltimore/Surr. Cntys | $923.51 | $174.12 |
| Beaumont | $798.49 | $162.93 |
| Brazoria | $856.49 | $164.36 |
| Chicago | $887.32 | $185.41 |
| Chico | $930.80 | $165.34 |
| Colorado | $910.22 | $167.11 |
| Connecticut | $926.55 | $174.36 |
| Dallas | $861.32 | $165.70 |
| Dc + Md/Va Suburbs | $1,003.02 | $180.29 |
| Delaware | $855.56 | $165.53 |
| Detroit | $848.96 | $174.99 |
| East St. Louis | $820.64 | $178.10 |
| El Centro | $930.87 | $165.41 |
| Fort Lauderdale | $885.63 | $178.14 |
| Fort Worth | $854.21 | $165.57 |
| Fresno | $930.80 | $165.34 |
| Galveston | $858.60 | $165.08 |
| Hanford-Corcoran | $930.80 | $165.34 |
| Hawaii, Guam | $959.21 | $165.12 |
| Houston | $866.11 | $172.58 |
| Idaho | $799.54 | $157.00 |
| Indiana | $804.82 | $157.39 |
| Iowa | $794.85 | $155.80 |
| Kansas | $788.29 | $156.93 |
| Kentucky | $782.98 | $162.10 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $998.93 | $172.70 |
| Madera | $930.80 | $165.34 |
| Manhattan | $999.05 | $187.50 |
| Merced | $930.80 | $165.34 |
| Metropolitan Boston | $1,010.04 | $176.14 |
| Metropolitan Kansas City | $820.29 | $164.48 |
| Metropolitan Philadelphia | $899.82 | $172.77 |
| Metropolitan St. Louis | $830.11 | $165.22 |
| Miami | $915.92 | $188.87 |
| Minnesota | $876.59 | $157.92 |
| Mississippi | $760.16 | $158.82 |
| Modesto | $930.80 | $165.34 |
| Montana** | $865.06 | $166.64 |
| Napa | $1,097.91 | $177.41 |
| Nebraska | $800.42 | $155.79 |
| Nevada** | $863.53 | $164.41 |
| New Hampshire | $893.27 | $166.22 |
| New Mexico | $807.32 | $166.87 |
| New Orleans | $823.93 | $166.72 |
| North Carolina | $811.29 | $159.67 |
| North Dakota** | $856.95 | $158.54 |
| Northern Nj | $990.38 | $180.22 |
| Nyc Suburbs/Long Island | $1,022.45 | $192.04 |
| Ohio | $801.76 | $164.11 |
| Oklahoma | $784.01 | $160.33 |
| Oxnard-Thousand Oaks-Ventura | $996.05 | $170.52 |
| Portland | $944.47 | $168.53 |
| Poughkpsie/N Nyc Suburbs | $942.73 | $177.97 |
| Puerto Rico | $872.90 | $166.80 |
| Queens | $1,011.66 | $186.14 |
| Redding | $930.80 | $165.34 |
| Rest Of California | $930.80 | $165.34 |
| Rest Of Florida | $839.89 | $172.21 |
| Rest Of Georgia | $788.97 | $165.98 |
| Rest Of Illinois | $809.36 | $171.71 |
| Rest Of Louisiana | $780.66 | $162.56 |
| Rest Of Maine | $801.58 | $159.04 |
| Rest Of Maryland | $873.93 | $167.14 |
| Rest Of Massachusetts | $902.90 | $167.48 |
| Rest Of Michigan | $803.41 | $165.76 |
| Rest Of Missouri | $764.11 | $162.07 |
| Rest Of New Jersey | $938.38 | $175.72 |
| Rest Of New York | $824.56 | $161.07 |
| Rest Of Oregon | $858.10 | $162.48 |
| Rest Of Pennsylvania | $804.54 | $163.40 |
| Rest Of Texas | $826.57 | $163.77 |
| Rest Of Washington | $902.04 | $166.62 |
| Rhode Island | $889.99 | $168.53 |
| Riverside-San Bernardino-Ontario | $935.27 | $169.81 |
| Sacramento-Roseville-Folsom | $981.98 | $169.73 |
| Salinas | $978.45 | $168.99 |
| San Diego-Chula Vista-Carlsbad | $1,005.39 | $170.09 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $1,168.24 | $183.47 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $1,167.77 | $183.01 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $1,194.46 | $187.35 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $1,192.55 | $185.44 |
| San Luis Obispo-Paso Robles | $962.16 | $166.67 |
| Santa Cruz-Watsonville | $1,018.06 | $169.49 |
| Santa Maria-Santa Barbara | $983.19 | $168.84 |
| Santa Rosa-Petaluma | $1,028.64 | $170.99 |
| Seattle (King Cnty) | $1,034.20 | $177.25 |
| South Carolina | $807.61 | $162.28 |
| South Dakota** | $855.99 | $157.58 |
| Southern Maine | $853.47 | $161.34 |
| Stockton | $930.80 | $165.34 |
| Suburban Chicago | $896.20 | $178.93 |
| Tennessee | $792.39 | $157.53 |
| Utah | $819.94 | $163.43 |
| Vallejo | $1,097.24 | $176.74 |
| Vermont | $851.03 | $159.60 |
| Virgin Islands | $872.90 | $166.80 |
| Virginia | $848.66 | $162.12 |
| Visalia | $930.80 | $165.34 |
| West Virginia | $775.47 | $168.55 |
| Wisconsin | $824.98 | $155.90 |
| Wyoming** | $861.52 | $163.11 |
| Yuba City | $930.80 | $165.34 |
50434 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.
$755.63
$1,062.63
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 | $967.45 | 1 |
| AL | $768.00 | 1 |
| AR | $755.63 | 1 |
| AZ | $840.51 | 1 |
| CA | $930.80–$1,194.46 | 29 |
| CO | $910.22 | 1 |
| CT | $926.55 | 1 |
| DC | $1,003.02 | 1 |
| DE | $855.56 | 1 |
| FL | $839.89–$915.92 | 3 |
| GA | $788.97–$879.87 | 2 |
| GU | $959.21 | 1 |
| HI | $959.21 | 1 |
| IA | $794.85 | 1 |
| ID | $799.54 | 1 |
| IL | $809.36–$896.20 | 4 |
| IN | $804.82 | 1 |
| KS | $788.29 | 1 |
| KY | $782.98 | 1 |
| LA | $780.66–$823.93 | 2 |
| MA | $902.90–$1,010.04 | 2 |
| MD | $873.93–$1,003.02 | 3 |
| ME | $801.58–$853.47 | 2 |
| MI | $803.41–$848.96 | 2 |
| MN | $876.59 | 1 |
| MO | $764.11–$830.11 | 3 |
| MS | $760.16 | 1 |
| MT | $865.06 | 1 |
| NC | $811.29 | 1 |
| ND | $856.95 | 1 |
| NE | $800.42 | 1 |
| NH | $893.27 | 1 |
| NJ | $938.38–$990.38 | 2 |
| NM | $807.32 | 1 |
| NV | $863.53 | 1 |
| NY | $824.56–$1,022.45 | 5 |
| OH | $801.76 | 1 |
| OK | $784.01 | 1 |
| OR | $858.10–$944.47 | 2 |
| PA | $804.54–$899.82 | 2 |
| PR | $872.90 | 1 |
| RI | $889.99 | 1 |
| SC | $807.61 | 1 |
| SD | $855.99 | 1 |
| TN | $792.39 | 1 |
| TX | $798.49–$906.06 | 8 |
| UT | $819.94 | 1 |
| VA | $848.66–$1,003.02 | 2 |
| VI | $872.90 | 1 |
| VT | $851.03 | 1 |
| WA | $902.04–$1,034.20 | 2 |
| WI | $824.98 | 1 |
| WV | $775.47 | 1 |
| WY | $861.52 | 1 |
How the 50434 rate is calculated
Each of 50434’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 · 50434
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.66Practice expense 21.83Malpractice 0.41
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 50434
The CMS indicators that decide how 50434 is paid alongside other services.
CMS payment indicators · 50434
Catheter conversion
| 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
50434 without 50 · national office
$865.08
Catheter conversion
50434-50 · Bilateral: 150%
$1,297.62
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).
50434 compared with similar codes
Compare codes
50434 vs 50433 vs 50435 vs 50432: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 50433Catheter placement
- 50433 describes placement of a nephroureteral catheter. Choose 50434 when the physician converts an existing nephrostomy catheter to that drainage route.
- 50435Nephrostomy exchange
- 50435 is for exchanging a nephrostomy catheter. Use 50434 when the procedure changes the catheter route through the ureter rather than simply replacing the nephrostomy catheter.
- 50432Nephrostomy placement
- 50432 describes placement of a nephrostomy catheter. It does not describe converting an existing nephrostomy catheter into a nephroureteral catheter.
50434 billing questions
When should 50434 be used instead of 50433?
Use 50434 when an existing nephrostomy catheter is converted to a nephroureteral catheter. Use 50433 for placement of a nephroureteral catheter rather than conversion of an existing nephrostomy catheter.
Is exchanging a nephrostomy catheter the same service?
No. A routine exchange of a nephrostomy catheter is reported with 50435; 50434 describes converting the existing access to a nephroureteral drainage route.
Can the nephrostogram or imaging guidance be billed separately?
Imaging guidance, related radiological supervision and interpretation, and a nephrostogram or ureterogram performed as part of the conversion are included in 50434.
What should the procedure note establish?
Document the existing nephrostomy access, the catheter manipulation through the ureter, and the final catheter course and position. Include imaging findings that support the conversion when imaging is performed.
How is bilateral conversion reported?
When conversion is performed on both sides, report modifier 50; CMS pays the bilateral procedure at 150%.
How does Medicare handle other procedures performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures in that session are paid at 50%. The code has a 0-day global period, and Medicare does not pay an assistant at surgery.
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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