Billing code 50606: Urothelial biopsyMedicare rate & RVUs
Reports endoluminal tissue sampling from the ureter or renal pelvis, typically during evaluation of a suspected upper urinary tract lesion.
Medicare pays $475.63 for 50606 nationally in the office and $125.92 in a hospital or facility. Local office rates run $418.47–$639.60.
Medicare rate · 50606
Urothelial biopsy
Swap in your local Medicare rate.
- Work RVUs
- 3.08
- Total RVUs
- 14.24
- Global days
- ZZZ
National rate · 2026
$475.63
Office setting, before claim adjustments.
See every locality for 50606 → · 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 50606 covers
A urologist obtains tissue from the inner lining of the ureter or renal pelvis using an instrument passed through the urinary tract. The sample may be taken when imaging, visual findings, or urine testing raise concern for an upper-tract lesion, including possible urothelial cancer. This is distinct from collecting urine or washings for cytology, which does not provide a tissue biopsy.
Code 50606 is an add-on and must be reported with a qualifying primary procedure; cystourethroscopy with ureteral catheterization, code 52005, is a common companion when it provides access. Document the side, sampled site, biopsy performed, clinical reason, and associated primary procedure. CMS includes payment for this add-on within the primary procedure’s global period. For bilateral work, report modifier 50; CMS pays the bilateral procedure at 150%.
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 50606 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
$418.47 to $639.60
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $424.91 | $118.91 |
| Alaska* | $544.43 | $171.99 |
| Arizona | $462.56 | $123.70 |
| Arkansas | $418.47 | $118.08 |
| Atlanta | $484.37 | $129.07 |
| Austin | $495.16 | $125.17 |
| Bakersfield | $506.86 | $123.58 |
| Baltimore/Surr. Cntys | $506.68 | $131.44 |
| Beaumont | $442.33 | $124.10 |
| Brazoria | $470.28 | $123.72 |
| Chicago | $495.45 | $143.99 |
| Chico | $505.68 | $122.40 |
| Colorado | $496.94 | $124.85 |
| Connecticut | $508.17 | $131.53 |
| Dallas | $473.22 | $124.91 |
| Dc + Md/Va Suburbs | $546.67 | $134.71 |
| Delaware | $470.48 | $124.97 |
| Detroit | $472.22 | $134.75 |
| East St. Louis | $460.42 | $138.69 |
| El Centro | $505.75 | $122.47 |
| Fort Lauderdale | $491.10 | $136.84 |
| Fort Worth | $469.80 | $124.99 |
| Fresno | $505.68 | $122.40 |
| Galveston | $471.64 | $124.38 |
| Hanford-Corcoran | $505.68 | $122.40 |
| Hawaii, Guam | $519.24 | $121.62 |
| Houston | $478.96 | $131.70 |
| Idaho | $439.84 | $118.11 |
| Indiana | $442.53 | $118.35 |
| Iowa | $437.02 | $117.04 |
| Kansas | $434.50 | $118.36 |
| Kentucky | $434.60 | $123.71 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $541.13 | $127.42 |
| Madera | $505.68 | $122.40 |
| Manhattan | $548.26 | $141.90 |
| Merced | $505.68 | $122.40 |
| Metropolitan Boston | $548.10 | $130.55 |
| Metropolitan Kansas City | $453.40 | $125.02 |
| Metropolitan Philadelphia | $494.79 | $130.75 |
| Metropolitan St. Louis | $458.40 | $125.48 |
| Miami | $510.79 | $146.75 |
| Minnesota | $476.65 | $116.80 |
| Mississippi | $422.19 | $121.09 |
| Modesto | $505.68 | $122.40 |
| Montana** | $475.60 | $125.89 |
| Napa | $589.82 | $128.91 |
| Nebraska | $439.65 | $116.87 |
| Nevada** | $473.76 | $123.70 |
| New Hampshire | $488.69 | $124.65 |
| New Mexico | $448.48 | $127.80 |
| New Orleans | $456.24 | $127.17 |
| North Carolina | $446.73 | $120.45 |
| North Dakota** | $467.69 | $117.99 |
| Northern Nj | $540.52 | $134.86 |
| Nyc Suburbs/Long Island | $561.59 | $145.79 |
| Ohio | $444.47 | $125.19 |
| Oklahoma | $434.19 | $121.91 |
| Oxnard-Thousand Oaks-Ventura | $538.88 | $125.53 |
| Portland | $513.75 | $125.22 |
| Poughkpsie/N Nyc Suburbs | $517.21 | $134.28 |
| Puerto Rico | $479.38 | $125.83 |
| Queens | $553.53 | $140.17 |
| Redding | $505.68 | $122.40 |
| Rest Of California | $505.68 | $122.40 |
| Rest Of Florida | $466.54 | $132.22 |
| Rest Of Georgia | $439.38 | $127.44 |
| Rest Of Illinois | $451.88 | $132.60 |
| Rest Of Louisiana | $433.74 | $124.25 |
| Rest Of Maine | $441.83 | $120.10 |
| Rest Of Maryland | $479.87 | $125.97 |
| Rest Of Massachusetts | $493.61 | $125.37 |
| Rest Of Michigan | $446.09 | $126.80 |
| Rest Of Missouri | $425.69 | $124.24 |
| Rest Of New Jersey | $514.10 | $132.22 |
| Rest Of New York | $453.69 | $121.47 |
| Rest Of Oregon | $470.22 | $121.91 |
| Rest Of Pennsylvania | $445.42 | $124.39 |
| Rest Of Texas | $456.00 | $124.13 |
| Rest Of Washington | $492.82 | $124.58 |
| Rhode Island | $488.00 | $126.75 |
| Riverside-San Bernardino-Ontario | $510.02 | $126.74 |
| Sacramento-Roseville-Folsom | $531.71 | $125.00 |
| Salinas | $529.76 | $124.45 |
| San Diego-Chula Vista-Carlsbad | $543.04 | $124.79 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $625.53 | $132.44 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $625.07 | $131.98 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $639.60 | $135.32 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $637.74 | $133.46 |
| San Luis Obispo-Paso Robles | $521.13 | $122.82 |
| Santa Cruz-Watsonville | $548.86 | $123.97 |
| Santa Maria-Santa Barbara | $531.97 | $124.21 |
| Santa Rosa-Petaluma | $554.46 | $125.02 |
| Seattle (King Cnty) | $559.91 | $130.82 |
| South Carolina | $446.31 | $123.18 |
| South Dakota** | $466.76 | $117.05 |
| Southern Maine | $467.46 | $120.90 |
| Stockton | $505.68 | $122.40 |
| Suburban Chicago | $496.37 | $137.22 |
| Tennessee | $436.74 | $118.85 |
| Utah | $452.70 | $123.98 |
| Vallejo | $589.17 | $128.25 |
| Vermont | $465.43 | $119.22 |
| Virgin Islands | $479.38 | $125.83 |
| Virginia | $465.59 | $121.83 |
| Visalia | $505.68 | $122.40 |
| West Virginia | $434.31 | $130.41 |
| Wisconsin | $451.29 | $116.27 |
| Wyoming** | $472.16 | $122.45 |
| Yuba City | $505.68 | $122.40 |
50606 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.
$418.47
$572.64
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 | $544.43 | 1 |
| AL | $424.91 | 1 |
| AR | $418.47 | 1 |
| AZ | $462.56 | 1 |
| CA | $505.68–$639.60 | 29 |
| CO | $496.94 | 1 |
| CT | $508.17 | 1 |
| DC | $546.67 | 1 |
| DE | $470.48 | 1 |
| FL | $466.54–$510.79 | 3 |
| GA | $439.38–$484.37 | 2 |
| GU | $519.24 | 1 |
| HI | $519.24 | 1 |
| IA | $437.02 | 1 |
| ID | $439.84 | 1 |
| IL | $451.88–$496.37 | 4 |
| IN | $442.53 | 1 |
| KS | $434.50 | 1 |
| KY | $434.60 | 1 |
| LA | $433.74–$456.24 | 2 |
| MA | $493.61–$548.10 | 2 |
| MD | $479.87–$546.67 | 3 |
| ME | $441.83–$467.46 | 2 |
| MI | $446.09–$472.22 | 2 |
| MN | $476.65 | 1 |
| MO | $425.69–$458.40 | 3 |
| MS | $422.19 | 1 |
| MT | $475.60 | 1 |
| NC | $446.73 | 1 |
| ND | $467.69 | 1 |
| NE | $439.65 | 1 |
| NH | $488.69 | 1 |
| NJ | $514.10–$540.52 | 2 |
| NM | $448.48 | 1 |
| NV | $473.76 | 1 |
| NY | $453.69–$561.59 | 5 |
| OH | $444.47 | 1 |
| OK | $434.19 | 1 |
| OR | $470.22–$513.75 | 2 |
| PA | $445.42–$494.79 | 2 |
| PR | $479.38 | 1 |
| RI | $488.00 | 1 |
| SC | $446.31 | 1 |
| SD | $466.76 | 1 |
| TN | $436.74 | 1 |
| TX | $442.33–$495.16 | 8 |
| UT | $452.70 | 1 |
| VA | $465.59–$546.67 | 2 |
| VI | $479.38 | 1 |
| VT | $465.43 | 1 |
| WA | $492.82–$559.91 | 2 |
| WI | $451.29 | 1 |
| WV | $434.31 | 1 |
| WY | $472.16 | 1 |
How the 50606 rate is calculated
Each of 50606’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 · 50606
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.08Practice expense 10.76Malpractice 0.40
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 50606
The CMS indicators that decide how 50606 is paid alongside other services.
CMS payment indicators · 50606
Urothelial biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
50606 without 50 · national office
$475.63
Urothelial biopsy
50606-50 · Bilateral: 150%
$713.45
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).
50606 compared with similar codes
Compare codes
50606 vs 52005 vs 52354 vs 52351: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 52005Ureteral catheterization
- 52005 describes cystourethroscopy with ureteral catheterization; 50606 is the add-on for endoluminal tissue biopsy, not the access procedure.
- 52354Upper urinary tract biopsy
- 52354 applies when biopsy and/or fulguration is performed through ureteroscopy or pyeloscopy; 50606 describes endoluminal biopsy reported with a qualifying primary procedure.
- 52351Ureteroscopy
- 52351 is diagnostic ureteroscopy or pyeloscopy. When tissue is biopsied during that endoscopic examination, consider the biopsy service described by 52354 rather than reporting diagnostic examination alone.
50606 billing questions
When should 50606 be chosen instead of 52354?
Use 50606 for endoluminal biopsy of the ureter or renal pelvis with a qualifying primary procedure. Code 52354 describes biopsy and/or fulguration performed with ureteroscopy or pyeloscopy.
Can 50606 be reported by itself?
No. It is an add-on code and must be reported with a qualifying primary procedure; 52005 is a common companion when ureteral catheterization provides access.
How is bilateral biopsy reported?
Report modifier 50 for bilateral work. CMS pays the bilateral procedure at 150%.
What documentation supports 50606?
Document the indication, side and site sampled, that tissue biopsy was performed, and the primary procedure reported with the add-on.
Is 50606 paid outside the primary procedure’s global period?
No. CMS includes payment for 50606 within the global period of the primary procedure.
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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