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CMS RVU26D · Effective 2026-10-01

50955 in Austin

Office / nonfacility

$452.83

Base rate per service

Facility setting

$310.41

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Urology

About 50955: Ureteroscopy with biopsy

Reports endoscopic examination of the ureter with tissue sampling, such as biopsy of a suspicious ureteral lesion during a facility-based procedure.

A urologist passes an endoscope into the ureter to inspect its lining and obtain tissue from a finding that needs pathologic evaluation. A typical clinical situation is sampling a suspicious upper-tract urothelial lesion. The service is commonly performed in a hospital or ambulatory surgery setting; Medicare recorded facility services for this code in 2024.

Report the code when the documented ureteroscopic service includes biopsy, and support it with the indication, ureter and side examined, endoscopic findings, and tissue-sampling details. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy family pricing applies. For bilateral procedures, modifier 50 is paid at 150%. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.

CMS billing rules for 50955

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Endoscopy family pricing applies when related endoscopies are performed together.
Bilateral procedures
Bilateral procedure with modifier 50 is paid at 150%.
Assistant at surgery
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU6.57 · 49%
  • Practice expense (office) RVU5.88 · 44%
  • Malpractice RVU0.85 · 6%

30

Medicare services in 2024 · #5674 by national volume

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.

50955 compared with similar codes

Office rates for Austin, from the same CMS release.

50951

Ureteroscopy

Diagnostic examination

$401.17

50951 represents diagnostic ureteroscopy. Choose 50955 when the documented ureteroscopic service also includes biopsy.

50957

Ureteroscopy

Endoscopic lesion treatment

$456.99

50957 is a ureteroscopic treatment code. This code is for ureteroscopy with biopsy rather than treatment-focused work.

50974

Ureteroscopy

Biopsy during ureteroscopy

No office rate

Both short descriptors identify ureteroscopic biopsy. Compare the full CPT descriptors and operative documentation to determine which service configuration was performed.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 50955 is $424.54—$28.29 lower than the $452.83 rate in Austin. Both use the same code, release and participation basis.

50955 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $452.83

  2. Beaumont

    $424.54

    $28.29 lower than Austin

  3. Brazoria

    $437.97

    $14.86 lower than Austin

  4. Dallas

    $441.39

    $11.44 lower than Austin

  5. Fort Worth

    $439.79

    $13.04 lower than Austin

  6. Galveston

    $439.73

    $13.10 lower than Austin

  7. Houston

    $455.29

    $2.46 higher than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 50955 ranges from $402.77 in Arkansas to $553.97 in Alaska*. This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas
  • Rest Of Texas

    Texas · 50955

    Office

    $431.46

    Facility

    $303.72

    $21.37 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 50955

    Office

    $479.63

    Facility

    $320.39

    $26.80 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 50955

    Office

    $494.25

    Facility

    $335.68

    $41.42 higher than Austin for the office setting.

  • Miami

    Florida · 50955

    Office

    $495.69

    Facility

    $355.57

    $42.86 higher than Austin for the office setting.

  • Chicago

    Illinois · 50955

    Office

    $483.52

    Facility

    $348.24

    $30.69 higher than Austin for the office setting.

  • Manhattan

    New York · 50955

    Office

    $506.73

    Facility

    $350.32

    $53.90 higher than Austin for the office setting.

  • Alaska*

    Alaska · 50955

    Office

    $553.97

    Facility

    $410.62

    $101.14 higher than Austin for the office setting.

  • Alabama

    Alabama · 50955

    Office

    $407.36

    Facility

    $289.58

    $45.47 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 50955

    Office

    $402.77

    Facility

    $287.14

    $50.06 lower than Austin for the office setting.

  • Arizona

    Arizona · 50955

    Office

    $434.06

    Facility

    $303.62

    $18.77 lower than Austin for the office setting.

  • Bakersfield

    California · 50955

    Office

    $456.15

    Facility

    $308.63

    $3.32 higher than Austin for the office setting.

  • Chico

    California · 50955

    Office

    $453.64

    Facility

    $306.12

    $0.81 higher than Austin for the office setting.

  • El Centro

    California · 50955

    Office

    $453.79

    Facility

    $306.26

    $0.96 higher than Austin for the office setting.

  • Fresno

    California · 50955

    Office

    $453.64

    Facility

    $306.12

    $0.81 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 50955

    Office

    $453.64

    Facility

    $306.12

    $0.81 higher than Austin for the office setting.

  • Madera

    California · 50955

    Office

    $453.64

    Facility

    $306.12

    $0.81 higher than Austin for the office setting.

  • Merced

    California · 50955

    Office

    $453.64

    Facility

    $306.12

    $0.81 higher than Austin for the office setting.

  • Modesto

    California · 50955

    Office

    $453.64

    Facility

    $306.12

    $0.81 higher than Austin for the office setting.

  • Napa

    California · 50955

    Office

    $506.54

    Facility

    $329.13

    $53.71 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 50955

    Office

    $475.42

    Facility

    $316.31

    $22.59 higher than Austin for the office setting.

  • Redding

    California · 50955

    Office

    $453.64

    Facility

    $306.12

    $0.81 higher than Austin for the office setting.

  • Rest Of California

    California · 50955

    Office

    $453.64

    Facility

    $306.12

    $0.81 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 50955

    Office

    $462.86

    Facility

    $315.33

    $10.03 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 50955

    Office

    $470.97

    Facility

    $314.43

    $18.14 higher than Austin for the office setting.

  • Salinas

    California · 50955

    Office

    $469.09

    Facility

    $313.08

    $16.26 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 50955

    Office

    $476.31

    Facility

    $315.32

    $23.48 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 50955

    Office

    $530.24

    Facility

    $340.45

    $77.41 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 50955

    Office

    $529.28

    Facility

    $339.48

    $76.45 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 50955

    Office

    $542.01

    Facility

    $347.90

    $89.18 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 50955

    Office

    $538.06

    Facility

    $343.96

    $85.23 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 50955

    Office

    $462.09

    Facility

    $308.77

    $9.26 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 50955

    Office

    $477.89

    Facility

    $314.35

    $25.06 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 50955

    Office

    $469.81

    Facility

    $312.85

    $16.98 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 50955

    Office

    $482.42

    Facility

    $317.12

    $29.59 higher than Austin for the office setting.

  • Stockton

    California · 50955

    Office

    $453.64

    Facility

    $306.12

    $0.81 higher than Austin for the office setting.

  • Vallejo

    California · 50955

    Office

    $505.15

    Facility

    $327.74

    $52.32 higher than Austin for the office setting.

  • Visalia

    California · 50955

    Office

    $453.64

    Facility

    $306.12

    $0.81 higher than Austin for the office setting.

  • Yuba City

    California · 50955

    Office

    $453.64

    Facility

    $306.12

    $0.81 higher than Austin for the office setting.

  • Colorado

    Colorado · 50955

    Office

    $453.22

    Facility

    $310.00

    $0.39 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 50955

    Office

    $469.71

    Facility

    $324.74

    $16.88 higher than Austin for the office setting.

  • Delaware

    Delaware · 50955

    Office

    $440.10

    Facility

    $307.11

    $12.73 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 50955

    Office

    $469.72

    Facility

    $333.37

    $16.89 higher than Austin for the office setting.

  • Rest Of Florida

    Florida · 50955

    Office

    $449.87

    Facility

    $321.19

    $2.96 lower than Austin for the office setting.

  • Atlanta

    Georgia · 50955

    Office

    $453.74

    Facility

    $316.98

    $0.91 higher than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 50955

    Office

    $428.47

    Facility

    $308.40

    $24.36 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 50955

    Office

    $459.19

    Facility

    $306.14

    $6.36 higher than Austin for the office setting.

  • Iowa

    Iowa · 50955

    Office

    $410.42

    Facility

    $287.25

    $42.41 lower than Austin for the office setting.

  • Idaho

    Idaho · 50955

    Office

    $413.56

    Facility

    $289.72

    $39.27 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 50955

    Office

    $457.31

    Facility

    $333.47

    $4.48 higher than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 50955

    Office

    $443.13

    Facility

    $320.23

    $9.70 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 50955

    Office

    $472.99

    Facility

    $334.75

    $20.16 higher than Austin for the office setting.

  • Indiana

    Indiana · 50955

    Office

    $415.30

    Facility

    $290.52

    $37.53 lower than Austin for the office setting.

  • Kansas

    Kansas · 50955

    Office

    $411.30

    Facility

    $289.61

    $41.53 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 50955

    Office

    $420.02

    Facility

    $300.35

    $32.81 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 50955

    Office

    $436.51

    Facility

    $309.84

    $16.32 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 50955

    Office

    $420.45

    Facility

    $301.33

    $32.38 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 50955

    Office

    $488.21

    Facility

    $327.49

    $35.38 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 50955

    Office

    $452.39

    Facility

    $310.65

    $0.44 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 50955

    Office

    $468.81

    Facility

    $324.38

    $15.98 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 50955

    Office

    $446.46

    Facility

    $310.23

    $6.37 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 50955

    Office

    $417.79

    Facility

    $293.95

    $35.04 lower than Austin for the office setting.

  • Southern Maine

    Maine · 50955

    Office

    $431.99

    Facility

    $298.59

    $20.84 lower than Austin for the office setting.

  • Detroit

    Michigan · 50955

    Office

    $456.83

    Facility

    $326.94

    $4.00 higher than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 50955

    Office

    $430.81

    Facility

    $307.91

    $22.02 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 50955

    Office

    $429.94

    Facility

    $291.43

    $22.89 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 50955

    Office

    $431.60

    Facility

    $305.20

    $21.23 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 50955

    Office

    $434.86

    Facility

    $306.72

    $17.97 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 50955

    Office

    $416.39

    Facility

    $300.36

    $36.44 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 50955

    Office

    $409.52

    Facility

    $293.63

    $43.31 lower than Austin for the office setting.

  • Montana**

    Montana · 50955

    Office

    $444.18

    Facility

    $309.57

    $8.65 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 50955

    Office

    $420.82

    Facility

    $295.24

    $32.01 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 50955

    Office

    $427.37

    Facility

    $292.76

    $25.46 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 50955

    Office

    $411.45

    Facility

    $287.21

    $41.38 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 50955

    Office

    $448.74

    Facility

    $308.61

    $4.09 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 50955

    Office

    $491.41

    Facility

    $335.27

    $38.58 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 50955

    Office

    $473.83

    Facility

    $326.84

    $21.00 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 50955

    Office

    $433.64

    Facility

    $310.20

    $19.19 lower than Austin for the office setting.

  • Nevada**

    Nevada · 50955

    Office

    $439.69

    Facility

    $304.95

    $13.14 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 50955

    Office

    $519.73

    Facility

    $359.68

    $66.90 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 50955

    Office

    $478.73

    Facility

    $331.33

    $25.90 higher than Austin for the office setting.

  • Queens

    New York · 50955

    Office

    $506.57

    Facility

    $347.47

    $53.74 higher than Austin for the office setting.

  • Rest Of New York

    New York · 50955

    Office

    $425.98

    Facility

    $298.10

    $26.85 lower than Austin for the office setting.

  • Ohio

    Ohio · 50955

    Office

    $427.37

    Facility

    $304.48

    $25.46 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 50955

    Office

    $416.89

    Facility

    $296.68

    $35.94 lower than Austin for the office setting.

  • Portland

    Oregon · 50955

    Office

    $462.28

    Facility

    $312.73

    $9.45 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 50955

    Office

    $435.01

    Facility

    $300.95

    $17.82 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 50955

    Office

    $461.71

    Facility

    $321.59

    $8.88 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 50955

    Office

    $426.57

    Facility

    $303.00

    $26.26 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 50955

    Office

    $445.97

    Facility

    $309.88

    $6.86 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 50955

    Office

    $451.82

    Facility

    $312.77

    $1.01 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 50955

    Office

    $425.05

    Facility

    $300.67

    $27.78 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 50955

    Office

    $425.38

    Facility

    $290.77

    $27.45 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 50955

    Office

    $413.21

    Facility

    $290.86

    $39.62 lower than Austin for the office setting.

  • Utah

    Utah · 50955

    Office

    $429.55

    Facility

    $303.02

    $23.28 lower than Austin for the office setting.

  • Virginia

    Virginia · 50955

    Office

    $432.55

    Facility

    $300.23

    $20.28 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 50955

    Office

    $445.97

    Facility

    $309.88

    $6.86 lower than Austin for the office setting.

  • Vermont

    Vermont · 50955

    Office

    $428.24

    Facility

    $294.98

    $24.59 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 50955

    Office

    $450.71

    Facility

    $308.97

    $2.12 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 50955

    Office

    $494.59

    Facility

    $329.43

    $41.76 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 50955

    Office

    $416.34

    Facility

    $287.38

    $36.49 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 50955

    Office

    $430.74

    Facility

    $313.77

    $22.09 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 50955

    Office

    $436.85

    Facility

    $302.24

    $15.98 lower than Austin for the office setting.

See how rates vary across the country

50955 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$402.77

$553.97

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$553.971
AL$407.361
AR$402.771
AZ$434.061
CA$453.64–$542.0129
CO$453.221
CT$469.711
DC$494.251
DE$440.101
FL$449.87–$495.693
GA$428.47–$453.742
GU$459.191
HI$459.191
IA$410.421
ID$413.561
IL$443.13–$483.524
IN$415.301
KS$411.301
KY$420.021
LA$420.45–$436.512
MA$452.39–$488.212
MD$446.46–$494.253
ME$417.79–$431.992
MI$430.81–$456.832
MN$429.941
MO$416.39–$434.863
MS$409.521
MT$444.181
NC$420.821
ND$427.371
NE$411.451
NH$448.741
NJ$473.83–$491.412
NM$433.641
NV$439.691
NY$425.98–$519.735
OH$427.371
OK$416.891
OR$435.01–$462.282
PA$426.57–$461.712
PR$445.971
RI$451.821
SC$425.051
SD$425.381
TN$413.211
TX$424.54–$455.298
UT$429.551
VA$432.55–$494.252
VI$445.971
VT$428.241
WA$450.71–$494.592
WI$416.341
WV$430.741
WY$436.851

Explore 50955 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Why are the office and facility amounts different?

For 50955 in Austin, the physician’s office rate is $452.83 and the facility-setting rate is $310.41: a difference of $142.42.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 50955 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$498.11

$452.83 × 110% = $498.11

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 50955 in Austin.

PPRRVU2026_Oct_nonQPP.csv

6,007

Code
50955
Physician work
6.57
Practice expense
5.88
Malpractice
0.85

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 50955 in Austin
ComponentRVULocality factorAdjusted
Physician work6.57× 1.0026.5831
Practice expense5.88× 1.0586.2210
Malpractice0.85× 0.8860.7531
Total RVUs13.5573
Conversion factor× 33.4009

Office / nonfacility rate, Austin$452.83

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 50955 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work6.571.002
Practice expense5.881.058
Malpractice0.850.886

(6.57 × 1.002 + 5.88 × 1.058 + 0.85 × 0.886) × $33.4009 = $452.83

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work6.571.002
Practice expense1.851.058
Malpractice0.850.886

(6.57 × 1.002 + 1.85 × 1.058 + 0.85 × 0.886) × $33.4009 = $310.41

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

50955 · Office / nonfacility

$452.83

Effective 2026-10-01

The base rate is $29.56 higher than on 2025-10-01, moving from $423.27 to $452.83 (7.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $423.27changed to$452.83

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.74 changed to 6.57
    • Practice expense RVU 5.35 changed to 5.88
    • Malpractice RVU 0.82 changed to 0.85
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $423.27

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$452.83$310.41RVU26D
2026-07-01$452.83$310.41RVU26C
2026-04-01$452.83$310.41RVU26B
2026-01-01$452.83$310.41RVU26A
2025-10-01$423.27$340.04RVU25D
2025-07-01$423.27$340.04RVU25C
2025-04-01$423.27$340.04RVU25B
2025-01-01$423.27$340.04RVU25A

50955 billing questions

When should this code be selected instead of diagnostic ureteroscopy?

Use this code when the ureteroscopic service includes biopsy. A diagnostic-only examination without tissue sampling is represented by a diagnostic ureteroscopy code, such as 50951.

Can the biopsy be reported separately from the ureteroscopy?

This code describes ureteroscopy with biopsy. The record should show the endoscopic examination and tissue sampling; do not treat the biopsy as an unrelated service merely because a specimen is sent to pathology.

How does CMS handle related endoscopies performed together?

Endoscopy family pricing applies when related endoscopies are performed together. The code’s payment is subject to that family pricing in the combined service.

How is a bilateral procedure reported?

For a bilateral procedure, report modifier 50; CMS pays the procedure at 150%. Document the ureteral work on both sides.

What assistant or co-surgeon rules apply?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 50955PPRRVU2026_Oct_nonQPP.csv, line 6,007 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)