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Billing code 50860: UreterostomyMedicare rate & RVUs

Reports surgery that brings a ureter to the skin to create an external urinary drainage route instead of a bowel-based diversion.

CMS RVU26DEffective Oct 1, 2026109 payment localities22 Medicare services in 2024

Medicare pays $850.39 for 50860 nationally in a facility.

Medicare rate · 50860

Ureterostomy

Swap in your local Medicare rate.

Work RVUs
16.65
Total RVUs
25.46
Global days
090

National rate · 2026

$850.39

Facility setting, before claim adjustments.

See every locality for 50860 → · 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 50860 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 50860 covers

Code 50860 represents surgery that brings a ureter to the skin and creates an external route for urine drainage. A urologist typically performs the operation in a hospital operating room when the planned diversion directs urine through a cutaneous opening rather than through bowel or a reconstructed bladder. The operative report should establish that the ureter was implanted at the skin; this is not a code for implanting a ureter into bowel or replacing a ureter with bowel.

Report the service for the operation performed, with documentation identifying the ureter or ureters and the side or sides treated. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same 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 services may be paid; 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 50860 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

50860 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$791.52
Alaska*Unavailable$1,110.84
ArizonaUnavailable$833.19
ArkansasUnavailable$784.31
AtlantaUnavailable$869.99
AustinUnavailable$856.27
BakersfieldUnavailable$854.39
Baltimore/Surr. CntysUnavailable$892.49
BeaumontUnavailable$825.26
BrazoriaUnavailable$837.11

50860 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
50860 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 50860 rate is calculated

Each of 50860’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 · 50860

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.65Practice expense 6.67Malpractice 2.14

25.4600 adjusted RVUs×$33.4009 conversion factor=$850.39

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

Payment rules and modifiers for 50860

50860 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 50860

Ureterostomy

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 · 50860

Ureterostomy

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

50860 without 50 · national facility

$850.39

Ureterostomy

50860-50 · Bilateral: 150%

$1,275.59

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

50860 compared with similar codes

Compare codes

50860 vs 50800 vs 50815 vs 50820 vs 50840: national Medicare rates

Swap in your local Medicare rate.

  • 50860
    Ureterostomy · 16.65 wRVU
    —
  • 50800
    Ureteral implantation · 16 wRVU
    —
  • 50815
    Urinary diversion · 21.7 wRVU
    —
  • 50820
    Urinary diversion · 23.47 wRVU
    —
  • 50840
    Ureteral reconstruction · 21.83 wRVU
    —

How to choose

50800Ureteral implantation
Use 50860 when the ureter is brought to the skin. Code 50800 concerns a ureter-to-bowel connection.
50815Urinary diversion
50860 creates a cutaneous drainage route; 50815 describes urinary diversion to intestine.
50820Urinary diversion
Choose 50860 for implantation of a ureter at the skin, not a bowel-based urinary diversion.
50840Ureteral reconstruction
50860 brings the ureter to the skin. Code 50840 is for replacing a ureter with bowel.

Codes related to 50860

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

Codes related to 50860
CodeHow it relatesNational office range
Used instead
50800Ureteral implantationImplants the ureter into bowel rather than creating a cutaneous outlet.No office rate
50815Urinary diversionProvides urinary diversion to intestine instead of directing the ureter to skin.No office rate
50820Urinary diversionUses bowel to construct a urinary diversion rather than a ureter-to-skin route.No office rate
50825Urinary diversionA bowel-based urinary diversion option, unlike direct cutaneous ureter drainage.No office rate
50840Ureteral reconstructionUses bowel to replace a ureter rather than implanting it at the skin.No office rate

50860 billing questions

How is 50860 different from implanting a ureter into bowel?

50860 is for bringing the ureter to the skin for external drainage. Code 50800 describes a bowel connection rather than a cutaneous outlet.

What operative documentation supports 50860?

The report should show that the surgeon brought and implanted the ureter at the skin. Document the side or sides treated and any other procedures performed in the session.

How is bilateral 50860 reported?

When the procedure is bilateral, report modifier 50; CMS pays the bilateral procedure at 150%.

Are related postoperative visits included?

Yes. 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 paid?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 50860PPRRVU2026_Oct_nonQPP.csv, line 5,996 (RVU26D)

Open CMS sourceHow we calculate rates

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