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Billing code 51065: Ureteral stone removalMedicare rate & RVUs

Reports operative removal of a ureteral calculus when the surgeon performs a ureterolithotomy rather than endoscopic extraction or stone fragmentation.

CMS RVU26DEffective Oct 1, 2026109 payment localities24 Medicare services in 2024

Medicare pays $530.07 for 51065 nationally in a facility.

Medicare rate · 51065

Ureteral stone removal

Work RVUs
9.7
Total RVUs
15.87
Global days
090

National rate · 2026

$530.07

Facility setting, before claim adjustments.

See every locality for 51065 →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 51065 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 51065 covers

A urologist performs an operative ureterolithotomy to remove a calculus lodged in the ureter. The service addresses a ureteral stone requiring surgical access and removal, rather than a stone in the bladder or one treated by endoscopic extraction or fragmentation. It is generally performed in a hospital operating room or another surgical facility.

Report the code when the operative note supports removal of a ureteral calculus by the procedure represented by this code. Document the stone’s ureteral location, the operative approach, and the work performed to remove it; distinguish the service from endoscopic ureteroscopic treatment and bladder stone removal. This is major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. 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 51065 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

51065 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$491.41
Alaska*Unavailable$684.00
ArizonaUnavailable$518.97
ArkansasUnavailable$486.65
AtlantaUnavailable$542.07
AustinUnavailable$535.49
BakersfieldUnavailable$535.68
Baltimore/Surr. CntysUnavailable$557.15
BeaumontUnavailable$512.32
BrazoriaUnavailable$522.00

51065 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
51065 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 51065 rate is calculated

Each of 51065’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 · 51065

RVUs × geographic indexes × conversion factor

Work9.70

9.70 RVUs× 1.000 GPCI

Practice expense4.92

4.92 RVUs× 1.000 GPCI

Malpractice1.25

1.25 RVUs× 1.000 GPCI

Adjusted RVUs

15.8700

Conversion factor

$33.4009

Medicare rate

$530.07

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 51065

51065 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 51065

Ureteral stone removal

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)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
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 · 51065

Ureteral stone removal

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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 51 · payment effect

With and without the modifier

51065 without 51 · national facility

$530.07

Ureteral stone removal

51065-51 · Second procedure: 50%

$265.04

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

51065 compared with similar codes

Compare codes · National

5 codes, side by side

  • 51065

    Ureteral stone removal9.7 wRVU

    Not priced

  • 51060

    Ureterolithotomy9.7 wRVU

    Not priced

  • 51050

    Bladder stone removal7.77 wRVU

    Not priced

  • 52352

    Ureteroscopy6.58 wRVU

    Not priced

  • 52353

    Stone lithotripsy7.31 wRVU

    Not priced

How to choose

51060Ureterolithotomy
Both codes concern operative removal of a ureteral calculus. Choose based on the exact procedure documented and the distinctions in the full code descriptors, not just the presence of a ureteral stone.
51050Bladder stone removal
Use 51050 for a bladder calculus. This code is for a calculus located in the ureter.
52352Ureteroscopy
Use 52352 when the surgeon extracts the stone through a ureteroscopic or pyeloscopic approach; this code represents operative ureteral stone removal.
52353Stone lithotripsy
Use 52353 for endoscopic fragmentation of a ureteral or renal calculus. This code represents operative removal rather than endoscopic fragmentation.

Codes related to 51065

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

Codes related to 51065
CodeHow it relatesNational office range
Same family
51060UreterolithotomyA related operative ureteral calculus removal code; select according to the specific procedure performed.No office rate
Used instead
51050Bladder stone removalFor operative removal of a bladder calculus, not a ureteral calculus.No office rate
52352UreteroscopyEndoscopic ureteroscopic or pyeloscopic extraction of a stone.No office rate
52353Stone lithotripsyEndoscopic ureteroscopic or pyeloscopic fragmentation of a stone.No office rate
50590Kidney stone treatmentShock-wave fragmentation is a different treatment approach for urinary calculi.$683.76–$953.31

51065 billing questions

How does this differ from ureteroscopic stone removal?

This code represents operative ureteral stone removal. Use an endoscopic ureteroscopy code when the surgeon accesses and treats the stone endoscopically instead.

Can bladder stone removal be reported instead?

No. Code 51050 is for a calculus in the bladder; this code concerns a calculus in the ureter.

Is modifier 50 appropriate for stones on both sides?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

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 surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

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

The highest-valued procedure is paid in full, and other procedures are subject to 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 51065PPRRVU2026_Oct_nonQPP.csv, line 6,021 (RVU26D)

Open CMS sourceHow we calculate rates

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