CPT code 50436: Nephrostomy tract dilation2026 Medicare rate & RVUs in Redding
Report this service when a clinician enlarges an established percutaneous nephrostomy tract to provide access for an endourologic procedure.
In Redding, Medicare pays $135.66 for 50436 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 50436 nationwide
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 11 sections
What 50436 covers
A urologist or interventional radiologist enlarges an established nephrostomy tract through the skin to accommodate instruments needed for an endourologic procedure, such as accessing the collecting system for stone treatment. The service may take place in an operating room or an image-guided procedure suite. Imaging guidance, such as ultrasound or fluoroscopy, is included when performed as part of the tract dilation.
Report the code for dilation of an existing tract, not for creating a new nephrostomy access or simply exchanging a catheter. The operative or procedure note should establish that the tract already existed, explain the endourologic purpose of dilation, and describe the work performed; document imaging guidance when used. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and the others at 50%. For bilateral reporting with modifier 50, payment is at 150%. Assistant-at-surgery payment is restricted; 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.
How Redding compares for 50436
Across 109 of 109 payment localities, the facility rate for 50436 runs from $125.80 in Arkansas to $178.50 in Alaska*. Redding pays $135.66. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Redding · this page$135.66
- Bakersfield · California$136.70+$1.04
- Chico · California$135.66
- El Centro · California$135.72+$0.06
- Fresno · California$135.66
- Hanford-Corcoran · California$135.66
- Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) · California$142.29+$6.63
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| MaderaCalifornia | — | $135.66 |
| MercedCalifornia | — | $135.66 |
| ModestoCalifornia | — | $135.66 |
| NapaCalifornia | — | $147.06 |
| Oxnard-Thousand Oaks-VenturaCalifornia | — | $140.60 |
| Rest Of CaliforniaCalifornia | — | $135.66 |
| Riverside-San Bernardino-OntarioCalifornia | — | $139.46 |
| Sacramento-Roseville-FolsomCalifornia | — | $139.66 |
| SalinasCalifornia | — | $139.07 |
| San Diego-Chula Vista-CarlsbadCalifornia | — | $140.31 |
| San Francisco-Oakland-Berkeley (Marin Cnty)California | — | $152.52 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)California | — | $152.12 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty)California | — | $155.87 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)California | — | $154.24 |
| San Luis Obispo-Paso RoblesCalifornia | — | $137.13 |
| Santa Cruz-WatsonvilleCalifornia | — | $140.08 |
| Santa Maria-Santa BarbaraCalifornia | — | $139.04 |
| Santa Rosa-PetalumaCalifornia | — | $141.33 |
| StocktonCalifornia | — | $135.66 |
| VallejoCalifornia | — | $146.49 |
| VisaliaCalifornia | — | $135.66 |
| Yuba CityCalifornia | — | $135.66 |
| Dc + Md/Va SuburbsDistrict of Columbia | — | $148.55 |
| MiamiFlorida | — | $155.55 |
| ChicagoIllinois | — | $152.22 |
| ManhattanNew York | — | $154.44 |
| Alaska*Alaska | — | $178.50 |
| AlabamaAlabama | — | $126.94 |
| ArkansasArkansas | — | $125.80 |
| ArizonaArizona | — | $133.54 |
| ColoradoColorado | — | $136.98 |
| ConnecticutConnecticut | — | $143.16 |
| DelawareDelaware | — | $135.14 |
| Fort LauderdaleFlorida | — | $146.16 |
| Rest Of FloridaFlorida | — | $140.66 |
| AtlantaGeorgia | — | $139.44 |
| Rest Of GeorgiaGeorgia | — | $134.84 |
| Hawaii, GuamHawaii | — | $136.02 |
| IowaIowa | — | $126.33 |
| IdahoIdaho | — | $127.39 |
| East St. LouisIllinois | — | $145.40 |
| Rest Of IllinoisIllinois | — | $139.89 |
| Suburban ChicagoIllinois | — | $146.85 |
| IndianaIndiana | — | $127.78 |
| KansasKansas | — | $127.21 |
| KentuckyKentucky | — | $131.50 |
| New OrleansLouisiana | — | $135.86 |
| Rest Of LouisianaLouisiana | — | $131.87 |
| Metropolitan BostonMassachusetts | — | $145.31 |
| Rest Of MassachusettsMassachusetts | — | $137.16 |
| Baltimore/Surr. CntysMaryland | — | $142.98 |
| Rest Of MarylandMaryland | — | $136.63 |
| Rest Of MaineMaine | — | $129.13 |
| Southern MaineMaine | — | $131.66 |
| DetroitMichigan | — | $143.10 |
| Rest Of MichiganMichigan | — | $134.82 |
| MinnesotaMinnesota | — | $129.03 |
| Metropolitan Kansas CityMissouri | — | $133.93 |
| Metropolitan St. LouisMissouri | — | $134.66 |
| Rest Of MissouriMissouri | — | $131.27 |
| MississippiMississippi | — | $128.49 |
| Montana**Montana | — | $136.25 |
| North CarolinaNorth Carolina | — | $129.77 |
| North Dakota**North Dakota | — | $129.33 |
| NebraskaNebraska | — | $126.38 |
| New HampshireNew Hampshire | — | $136.21 |
| Northern NjNew Jersey | — | $148.22 |
| Rest Of New JerseyNew Jersey | — | $144.16 |
| New MexicoNew Mexico | — | $135.80 |
| Nevada**Nevada | — | $134.36 |
| Nyc Suburbs/Long IslandNew York | — | $158.53 |
| Poughkpsie/N Nyc SuburbsNew York | — | $146.04 |
| QueensNew York | — | $153.44 |
| Rest Of New YorkNew York | — | $131.10 |
| OhioOhio | — | $133.41 |
| OklahomaOklahoma | — | $130.02 |
| PortlandOregon | — | $138.51 |
| Rest Of OregonOregon | — | $132.67 |
| Metropolitan PhiladelphiaPennsylvania | — | $141.56 |
| Rest Of PennsylvaniaPennsylvania | — | $132.84 |
| Puerto RicoPuerto Rico | — | $136.48 |
| Rhode IslandRhode Island | — | $137.86 |
| South CarolinaSouth Carolina | — | $131.93 |
| South Dakota**South Dakota | — | $128.51 |
| TennesseeTennessee | — | $127.76 |
| AustinTexas | — | $137.10 |
| BeaumontTexas | — | $132.38 |
| BrazoriaTexas | — | $134.12 |
| DallasTexas | — | $135.29 |
| Fort WorthTexas | — | $135.11 |
| GalvestonTexas | — | $134.75 |
| HoustonTexas | — | $141.16 |
| Rest Of TexasTexas | — | $133.40 |
| UtahUtah | — | $133.04 |
| VirginiaVirginia | — | $132.26 |
| Virgin IslandsUnited States Virgin Islands | — | $136.48 |
| VermontVermont | — | $130.16 |
| Rest Of WashingtonWashington | — | $136.46 |
| Seattle (King Cnty)Washington | — | $146.40 |
| WisconsinWisconsin | — | $126.76 |
| West VirginiaWest Virginia | — | $136.85 |
| Wyoming**Wyoming | — | $133.24 |
50436 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 50436 rate is calculated
Each of 50436’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 · 50436
RVUs × geographic indexes × conversion factor
Work2.71
2.71 RVUs× 1.000 GPCI
Practice expense1.02
1.02 RVUs× 1.000 GPCI
Malpractice0.35
0.35 RVUs× 1.000 GPCI
Adjusted RVUs
4.0800
Conversion factor
$33.4009
Medicare rate
$136.28
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Redding inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,923
- Code
- 50436
- Physician work
- 2.71
- Practice expense
- 1.02
- Malpractice
- 0.35
GPCI2026.csv
19
- Locality
- Redding
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.71 | × 1.017 | 2.7561 |
| Practice expense | 1.02 | × 1.096 | 1.1179 |
| Malpractice | 0.35 | × 0.536 | 0.1876 |
| Total RVUs | 4.0616 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Redding$135.66
Facility: (2.71 × 1.017 + 1.02 × 1.096 + 0.35 × 0.536) × $33.4009 = $135.66
Payment rules and modifiers for 50436
The CMS indicators that decide how 50436 is paid alongside other services.
CMS payment indicators · 50436
Nephrostomy tract dilation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
50436 without 50 · national facility
$136.28
Nephrostomy tract dilation
50436-50 · Bilateral: 150%
$204.42
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).
How 50436 has changed in Redding
50436 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
January 1, 2019
RVU19A
No ratechanged toNo rate
Held through RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $135.66 | RVU26D |
| 2026-07-01 | Not available in this setting | $135.66 | RVU26C |
| 2026-04-01 | Not available in this setting | $135.66 | RVU26B |
| 2026-01-01 | Not available in this setting | $135.66 | RVU26A |
| 2025-10-01 | Not available in this setting | $146.64 | RVU25D |
| 2025-07-01 | Not available in this setting | $146.64 | RVU25C |
| 2025-04-01 | Not available in this setting | $146.64 | RVU25B |
| 2025-01-01 | Not available in this setting | $146.64 | RVU25A |
| 2024-10-01 | Not available in this setting | $146.90 | RVU24D |
| 2024-07-01 | Not available in this setting | $146.90 | RVU24C |
| 2024-04-01 | Not available in this setting | $146.90 | RVU24B |
| 2024-03-09 | Not available in this setting | $146.90 | RVU24AR |
| 2024-01-01 | Not available in this setting | $144.51 | RVU24A |
| 2023-10-01 | Not available in this setting | $149.04 | RVU23D |
| 2023-07-01 | Not available in this setting | $149.04 | RVU23C |
| 2023-04-01 | Not available in this setting | $149.04 | RVU23B |
| 2023-01-01 | Not available in this setting | $149.04 | RVU23A |
| 2022-10-01 | Not available in this setting | $152.66 | RVU22D |
| 2022-07-01 | Not available in this setting | $152.66 | RVU22C |
| 2022-04-01 | Not available in this setting | $152.66 | RVU22B |
| 2022-01-01 | Not available in this setting | $152.66 | RVU22A |
| 2021-10-01 | Not available in this setting | $153.93 | RVU21D |
| 2021-07-01 | Not available in this setting | $153.93 | RVU21C |
| 2021-04-01 | Not available in this setting | $153.93 | RVU21B |
| 2021-01-01 | Not available in this setting | $153.93 | RVU21A |
| 2020-10-01 | Not available in this setting | $158.59 | RVU20D |
| 2020-07-01 | Not available in this setting | $158.59 | RVU20C |
| 2020-04-01 | Not available in this setting | $158.59 | RVU20B |
| 2020-01-01 | Not available in this setting | $158.59 | RVU20A |
| 2019-10-01 | Not available in this setting | $158.75 | RVU19D |
| 2019-07-01 | Not available in this setting | $158.75 | RVU19C |
| 2019-04-01 | Not available in this setting | $158.75 | RVU19B |
| 2019-01-01 | Not available in this setting | $158.75 | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Redding rate applies
Redding is a Medicare payment area, not a city. Our Census mapping connects it to 32 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
50436 billing questions
How is this different from code 50437?
Both codes describe nephrostomy-tract dilation for endourologic access, but they distinguish access circumstances. Review the operative documentation and the applicable CPT descriptor to determine which tract-dilation service was performed.
Can this code be used for a routine nephrostomy catheter exchange?
No. Code 50436 describes dilation of an existing tract for endourologic access, not routine catheter exchange; code 50435 describes nephrostomy catheter exchange.
Is imaging guidance separately reported?
Imaging guidance is included in the tract-dilation service when performed. The code does not describe a standalone diagnostic nephrostogram or ureterogram.
What documentation supports reporting this code?
Document that the nephrostomy tract was established before the service, why it needed enlargement for an endourologic procedure, and the dilation performed. Include the imaging guidance used, if any.
How does Medicare handle bilateral reporting and multiple procedures?
When reported bilaterally with modifier 50, payment is at 150%. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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
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