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Billing code 50820: Urinary diversionMedicare rate & RVUs

Reports urinary diversion with a continent intestinal reservoir, such as an Indiana pouch, generally created with cystectomy and ureteral implantation.

CMS RVU26DEffective Oct 1, 2026109 payment localities820 Medicare services in 2024

Medicare pays $1,178.72 for 50820 nationally in a facility.

Medicare rate · 50820

Urinary diversion

Swap in your local Medicare rate.

Work RVUs
23.47
Total RVUs
35.29
Global days
090

National rate · 2026

$1,178.72

Facility setting, before claim adjustments.

See every locality for 50820 → · 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 50820 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 50820 covers

A urologist constructs a reservoir from bowel to store urine and connects the ureters to it, with a continent outlet that can be emptied by catheterization. An Indiana pouch is a familiar example. The operation is commonly performed in a hospital for patients needing urinary diversion, including after bladder removal for cancer. The service includes cystectomy as part of the diversion when performed; the operative report should identify the reservoir and its continent method of emptying.

Choose this code for a continent intestinal reservoir, not an ileal conduit or sigmoid bladder diversion. Documentation should describe the bowel reservoir, ureteral connections, outlet, and whether cystectomy was performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. A bilateral procedure reported with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is 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 50820 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

50820 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,095.83
Alaska*Unavailable$1,540.54
ArizonaUnavailable$1,154.21
ArkansasUnavailable$1,085.71
AtlantaUnavailable$1,207.47
AustinUnavailable$1,184.51
BakersfieldUnavailable$1,178.65
Baltimore/Surr. CntysUnavailable$1,237.88
BeaumontUnavailable$1,145.25
BrazoriaUnavailable$1,158.53

50820 rates by state

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

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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
50820 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 50820 rate is calculated

Each of 50820’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 · 50820

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 23.47Practice expense 8.57Malpractice 3.25

35.2900 adjusted RVUs×$33.4009 conversion factor=$1,178.72

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

Payment rules and modifiers for 50820

50820 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 50820

Urinary diversion

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.08/0.83/0.09Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 50820

Urinary diversion

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

50820 without 50 · national facility

$1,178.72

Urinary diversion

50820-50 · Bilateral: 150%

$1,768.08

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

50820 compared with similar codes

Compare codes

50820 vs 50825 vs 50815 vs 50810: national Medicare rates

Swap in your local Medicare rate.

  • 50820
    Urinary diversion · 23.47 wRVU
    —
  • 50825
    Urinary diversion · 29.91 wRVU
    —
  • 50815
    Urinary diversion · 21.7 wRVU
    —
  • 50810
    Ureter-bowel connection · 22.04 wRVU
    —

How to choose

50825Urinary diversion
Use 50820 for a continent intestinal reservoir. Use 50825 for diversion through an ileal conduit or sigmoid bladder.
50815Urinary diversion
50815 describes urinary diversion with ureterosigmoidostomy; 50820 describes a continent intestinal reservoir, such as an Indiana pouch.
50810Ureter-bowel connection
50810 is for ureterosigmoidostomy with creation of a sigmoid bladder and bilateral ureteral implantation, not a continent catheterized intestinal reservoir.

Codes related to 50820

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

Codes related to 50820
CodeHow it relatesNational office range
Same family
50825Urinary diversionSibling urinary diversion code for an ileal conduit or sigmoid bladder rather than a continent reservoir.No office rate
Used instead
50815Urinary diversionA ureterosigmoidostomy diversion is a different urinary-diversion configuration.No office rate
50810Ureter-bowel connectionDescribes ureterosigmoidostomy with sigmoid bladder creation and bilateral ureteral implantation.No office rate

50820 billing questions

How does this differ from 50825?

50820 is for a continent intestinal reservoir, such as an Indiana pouch. 50825 describes a diversion using an ileal conduit or sigmoid bladder.

Is cystectomy included?

Cystectomy is included in the urinary-diversion service when performed as part of the operation. The operative report should establish the diversion and whether the bladder was removed.

Can bowel reconstruction steps be billed separately?

Do not separately report steps integral to creating the same reservoir and urinary diversion. The record should make clear that the reconstruction is a continent intestinal reservoir.

What does the 90-day global period include?

It includes the day-before preoperative visit and 90 days of related postoperative care.

How are multiple procedures and bilateral reporting handled?

For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. A bilateral procedure reported with modifier 50 is paid at 150%.

May an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; team surgery is 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 50820PPRRVU2026_Oct_nonQPP.csv, line 5,991 (RVU26D)

Open CMS sourceHow we calculate rates

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