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Billing code 50840: Ureteral reconstructionMedicare rate & RVUs

Replaces a damaged or missing ureteral segment with bowel to restore urine flow from the kidney toward the bladder.

CMS RVU26DEffective Oct 1, 2026109 payment localities25 Medicare services in 2024

Medicare pays $1,103.57 for 50840 nationally in a facility.

Medicare rate · 50840

Ureteral reconstruction

Swap in your local Medicare rate.

Work RVUs
21.83
Total RVUs
33.04
Global days
090

National rate · 2026

$1,103.57

Facility setting, before claim adjustments.

See every locality for 50840 → · 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 50840 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 50840 covers

This operation uses a segment of bowel, commonly ileum, to bridge a damaged or missing portion of a ureter and carry urine toward the bladder. A urologist performs the reconstruction in an operating room, typically for a long ureteral defect or severe stricture that cannot be managed by a shorter repair. The bowel segment is joined to the urinary tract at each end to restore continuity.

Report the code when the bowel segment substitutes for the ureter, not when a ureter is simply implanted into bowel as a diversion. The operative report should identify the affected side or sides, the defect, the bowel segment, and the reconstruction performed. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 50840 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

50840 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,027.76
Alaska*Unavailable$1,444.23
ArizonaUnavailable$1,081.35
ArkansasUnavailable$1,018.49
AtlantaUnavailable$1,129.11
AustinUnavailable$1,110.60
BakersfieldUnavailable$1,107.66
Baltimore/Surr. CntysUnavailable$1,157.96
BeaumontUnavailable$1,071.65
BrazoriaUnavailable$1,086.23

50840 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
50840 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 50840 rate is calculated

Each of 50840’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 · 50840

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 21.83Practice expense 8.40Malpractice 2.81

33.0400 adjusted RVUs×$33.4009 conversion factor=$1,103.57

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

Payment rules and modifiers for 50840

50840 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 50840

Ureteral reconstruction

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 · 50840

Ureteral reconstruction

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

50840 without 50 · national facility

$1,103.57

Ureteral reconstruction

50840-50 · Bilateral: 150%

$1,655.36

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

50840 compared with similar codes

Compare codes

50840 vs 50800 vs 50810 vs 50820: national Medicare rates

Swap in your local Medicare rate.

  • 50840
    Ureteral reconstruction · 21.83 wRVU
    —
  • 50800
    Ureteral implantation · 16 wRVU
    —
  • 50810
    Ureter-bowel connection · 22.04 wRVU
    —
  • 50820
    Urinary diversion · 23.47 wRVU
    —

How to choose

50800Ureteral implantation
Choose 50840 when bowel substitutes for a damaged ureteral segment. Code 50800 describes implantation of the ureter into bowel.
50810Ureter-bowel connection
Code 50810 describes a ureter-to-bowel diversion connection; 50840 reconstructs the ureter using bowel as its replacement segment.
50820Urinary diversion
Code 50820 is for urinary diversion through an intestinal conduit. Code 50840 uses bowel to replace a ureteral segment and restore its continuity.

Codes related to 50840

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

Codes related to 50840
CodeHow it relatesNational office range
Used instead
50800Ureteral implantationImplants the ureter into bowel rather than replacing a ureteral segment with bowel.No office rate
50810Ureter-bowel connectionCreates a ureter-to-bowel connection for diversion rather than substituting bowel for the ureter.No office rate
50820Urinary diversionUses an intestinal conduit for urinary diversion instead of reconstructing the ureter with a bowel segment.No office rate

50840 billing questions

How does this differ from implanting a ureter into bowel?

This service uses bowel to replace a ureteral segment and restore the route toward the bladder. Implanting a ureter into bowel is a urinary diversion, not ureter replacement.

What documentation supports reporting this code?

The operative report should describe the ureteral defect, the bowel segment used, the connections made, and the side or sides reconstructed.

How is bilateral ureter replacement reported?

When both ureters are replaced in the same session, report the bilateral procedure with modifier 50. CMS pays the bilateral procedure at 150%.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How are other procedures in the same session paid?

CMS pays the highest-valued procedure in full and other procedures at 50% under the standard multiple procedure reduction.

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 50840PPRRVU2026_Oct_nonQPP.csv, line 5,994 (RVU26D)

Open CMS sourceHow we calculate rates

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