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Billing code 50437: Renal access dilationMedicare rate & RVUs

Percutaneous dilation with new access into the renal collecting system is reported to create a route for an endourologic procedure such as stone treatment.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.9K Medicare services in 2024

Medicare pays $224.12 for 50437 nationally in a facility.

Medicare rate · 50437

Renal access dilation

Swap in your local Medicare rate.

Work RVUs
4.73
Total RVUs
6.71
Global days
000

National rate · 2026

$224.12

Facility setting, before claim adjustments.

See every locality for 50437 → · 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 50437 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 50437 covers

This service enlarges an existing percutaneous tract and establishes new access into the renal collecting system for an endourologic procedure. A urologist or interventional radiologist may perform it to create a route for percutaneous stone treatment or antegrade endoscopy. Ultrasound and/or fluoroscopy may guide the access and dilation; that guidance is included in the service when performed. The defining feature is new collecting-system access, not dilation of an existing tract alone.

Report 50437 when the operative or procedure note supports both tract dilation and new access into the collecting system. Documentation should identify the existing tract, the new access, the purpose of the route, and the side treated. 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 procedure is paid in full and the others at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery services are not paid; 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 50437 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

50437 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$209.97
Alaska*Unavailable$297.63
ArizonaUnavailable$219.92
ArkansasUnavailable$208.25
AtlantaUnavailable$229.17
AustinUnavailable$225.00
BakersfieldUnavailable$224.20
Baltimore/Surr. CntysUnavailable$234.60
BeaumontUnavailable$218.53
BrazoriaUnavailable$220.77

50437 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
50437 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 50437 rate is calculated

Each of 50437’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 · 50437

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.73Practice expense 1.41Malpractice 0.57

6.7100 adjusted RVUs×$33.4009 conversion factor=$224.12

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

Payment rules and modifiers for 50437

The CMS indicators that decide how 50437 is paid alongside other services.

CMS payment indicators · 50437

Renal access dilation

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

50437 without 50 · national facility

$224.12

Renal access dilation

50437-50 · Bilateral: 150%

$336.18

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

50437 compared with similar codes

Compare codes

50437 vs 50436 vs 50432 vs 50433: national Medicare rates

Swap in your local Medicare rate.

  • 50437
    Renal access dilation · 4.73 wRVU
    —
  • 50436
    Nephrostomy tract dilation · 2.71 wRVU
    —
  • 50432
    Nephrostomy placement · 3.9 wRVU
    $864.08
  • 50433
    Catheter placement · 4.92 wRVU
    $1,074.84

How to choose

50436Nephrostomy tract dilation
Use 50437 when the dilated tract is used to establish new access into the renal collecting system. Use 50436 for dilation of an existing tract without that new access.
50432Nephrostomy placement
50432 reports placement of a nephrostomy catheter. 50437 reports tract dilation with new collecting-system access for an endourologic procedure.
50433Catheter placement
50433 reports placement of a nephroureteral catheter. 50437 describes dilation and new renal collecting-system access, not catheter placement as its defining service.

Codes related to 50437

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

Codes related to 50437
CodeHow it relatesNational office range
Same family
50436Nephrostomy tract dilationDilation of an existing tract without new access into the renal collecting system.No office rate
Used instead
50432Nephrostomy placementPlacement of a nephrostomy catheter for drainage rather than access dilation for an endourologic procedure.$755.67–$1,189.75
50433Catheter placementPlacement of a nephroureteral catheter, a catheter-placement service rather than new access dilation.$940.37–$1,479.32

50437 billing questions

How does 50437 differ from 50436?

50437 includes dilation of an existing tract with new access into the renal collecting system. 50436 describes dilation of an existing tract without that new access.

Is imaging guidance separately reported?

Imaging guidance, such as ultrasound or fluoroscopy, is included when performed as part of 50437.

What documentation supports 50437?

The record should show the existing percutaneous tract, its dilation, and creation of new access into the renal collecting system, including the side and procedural purpose.

How does CMS handle multiple procedures in the same session?

CMS pays the highest-valued procedure in full and other procedures at 50% when performed in the same session.

Can an assistant or co-surgeon be reported?

CMS does not pay an assistant at surgery 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
RVUs for 50437PPRRVU2026_Oct_nonQPP.csv, line 5,924 (RVU26D)

Open CMS sourceHow we calculate rates

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