Billing code 50551: Renal endoscopyMedicare rate & RVUs

Medicare pays $377.10 for 50551 nationally in the office and $259.52 in a hospital or facility. Local office rates run $341.55–$468.77.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 50551 covers

A urologist uses an endoscope passed through an existing nephrostomy or pyelostomy tract to examine the renal collecting system, including the renal pelvis and calyces. The service may include irrigation, instillation, or ureteropyelography. A typical setting is a hospital facility where a patient already has percutaneous access, such as access created to drain an obstructed collecting system. The defining feature is use of an established tract, rather than creating a new opening for the endoscope.

Report this code when the documented service is renal endoscopy through that established access and does not instead involve a separately specified biopsy or treatment procedure. The operative note should identify the access route, side, structures examined, and any included maneuvers. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral reporting with modifier 50, payment is 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment requires documented medical necessity; 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 50551 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

50551 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 50551 rate is calculated

Each of 50551’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.

Payment rules and modifiers for 50551

The CMS indicators that decide how 50551 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

50551 compared with similar codes

How to choose

50553Kidney endoscopy

Both describe diagnostic renal endoscopy, but the access route differs: 50551 uses an established nephrostomy or pyelostomy, while 50553 uses nephrotomy or pyelotomy.

50555Kidney endoscopy

Use the biopsy code when renal endoscopy includes tissue sampling; 50551 describes the established-access endoscopy without that biopsy service.

50557Renal endoscopy

Use the treatment code when the endoscopy includes treatment of a lesion. 50551 is the diagnostic established-access service.

50570Renal endoscopy

50570 concerns endoscopy of the ureter through ureterotomy. 50551 reaches the kidney’s collecting system through an established nephrostomy or pyelostomy.

Codes related to 50551

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

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

Open CMS sourceHow we calculate rates