No office rate
This is the related tract-dilation code for an existing nephrostomy access used for an endourologic procedure. Code 50437 represents a different access circumstance; select based on the documented tract and procedure.
On this page
CMS RVU26D · Effective 2026-10-01
50436 in Tennessee
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$127.76
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.
Urinary tract procedure
About 50436: Dilation of existing nephrostomy tract
Report this service when a clinician enlarges an established percutaneous nephrostomy tract to provide access for an endourologic procedure.
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.
CMS billing rules for 50436
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.71 · 66%
- Practice expense (office) RVU1.02 · 25%
- Malpractice RVU0.35 · 9%
1.5K
Medicare services in 2024 · #2651 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.
50436 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$791.96
Use 50432 for percutaneous placement of a nephrostomy catheter. Use 50436 when the service is enlargement of an established nephrostomy tract for endourologic access.
$515.09
Use 50435 for exchange of a nephrostomy catheter. Code 50436 describes dilation of the tract to permit endourologic access, not routine catheter exchange.
The same code, a different location
How does Tennessee compare?
50436 across payment areas
Same release and payment basis · bars start at $0
Tennessee · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Tennessee appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
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
Alabama
Alabama · 50436
Office
Unavailable
Facility
$126.94
No comparable office rate is available.
Arkansas
Arkansas · 50436
Office
Unavailable
Facility
$125.80
No comparable office rate is available.
Arizona
Arizona · 50436
Office
Unavailable
Facility
$133.54
No comparable office rate is available.
Bakersfield
California · 50436
Office
Unavailable
Facility
$136.70
No comparable office rate is available.
Chico
California · 50436
Office
Unavailable
Facility
$135.66
No comparable office rate is available.
El Centro
California · 50436
Office
Unavailable
Facility
$135.72
No comparable office rate is available.
Fresno
California · 50436
Office
Unavailable
Facility
$135.66
No comparable office rate is available.
Hanford-Corcoran
California · 50436
Office
Unavailable
Facility
$135.66
No comparable office rate is available.
Madera
California · 50436
Office
Unavailable
Facility
$135.66
No comparable office rate is available.
Merced
California · 50436
Office
Unavailable
Facility
$135.66
No comparable office rate is available.
Modesto
California · 50436
Office
Unavailable
Facility
$135.66
No comparable office rate is available.
Napa
California · 50436
Office
Unavailable
Facility
$147.06
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 50436
Office
Unavailable
Facility
$140.60
No comparable office rate is available.
Redding
California · 50436
Office
Unavailable
Facility
$135.66
No comparable office rate is available.
Rest Of California
California · 50436
Office
Unavailable
Facility
$135.66
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 50436
Office
Unavailable
Facility
$139.46
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 50436
Office
Unavailable
Facility
$139.66
No comparable office rate is available.
Salinas
California · 50436
Office
Unavailable
Facility
$139.07
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 50436
Office
Unavailable
Facility
$140.31
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 50436
Office
Unavailable
Facility
$152.52
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 50436
Office
Unavailable
Facility
$152.12
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 50436
Office
Unavailable
Facility
$155.87
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 50436
Office
Unavailable
Facility
$154.24
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 50436
Office
Unavailable
Facility
$137.13
No comparable office rate is available.
Santa Cruz-Watsonville
California · 50436
Office
Unavailable
Facility
$140.08
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 50436
Office
Unavailable
Facility
$139.04
No comparable office rate is available.
Santa Rosa-Petaluma
California · 50436
Office
Unavailable
Facility
$141.33
No comparable office rate is available.
Stockton
California · 50436
Office
Unavailable
Facility
$135.66
No comparable office rate is available.
Vallejo
California · 50436
Office
Unavailable
Facility
$146.49
No comparable office rate is available.
Visalia
California · 50436
Office
Unavailable
Facility
$135.66
No comparable office rate is available.
Yuba City
California · 50436
Office
Unavailable
Facility
$135.66
No comparable office rate is available.
Colorado
Colorado · 50436
Office
Unavailable
Facility
$136.98
No comparable office rate is available.
Connecticut
Connecticut · 50436
Office
Unavailable
Facility
$143.16
No comparable office rate is available.
Delaware
Delaware · 50436
Office
Unavailable
Facility
$135.14
No comparable office rate is available.
Fort Lauderdale
Florida · 50436
Office
Unavailable
Facility
$146.16
No comparable office rate is available.
Rest Of Florida
Florida · 50436
Office
Unavailable
Facility
$140.66
No comparable office rate is available.
Atlanta
Georgia · 50436
Office
Unavailable
Facility
$139.44
No comparable office rate is available.
Rest Of Georgia
Georgia · 50436
Office
Unavailable
Facility
$134.84
No comparable office rate is available.
Hawaii, Guam
Hawaii · 50436
Office
Unavailable
Facility
$136.02
No comparable office rate is available.
Iowa
Iowa · 50436
Office
Unavailable
Facility
$126.33
No comparable office rate is available.
Idaho
Idaho · 50436
Office
Unavailable
Facility
$127.39
No comparable office rate is available.
East St. Louis
Illinois · 50436
Office
Unavailable
Facility
$145.40
No comparable office rate is available.
Rest Of Illinois
Illinois · 50436
Office
Unavailable
Facility
$139.89
No comparable office rate is available.
Suburban Chicago
Illinois · 50436
Office
Unavailable
Facility
$146.85
No comparable office rate is available.
Indiana
Indiana · 50436
Office
Unavailable
Facility
$127.78
No comparable office rate is available.
Kansas
Kansas · 50436
Office
Unavailable
Facility
$127.21
No comparable office rate is available.
Kentucky
Kentucky · 50436
Office
Unavailable
Facility
$131.50
No comparable office rate is available.
New Orleans
Louisiana · 50436
Office
Unavailable
Facility
$135.86
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 50436
Office
Unavailable
Facility
$131.87
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 50436
Office
Unavailable
Facility
$145.31
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 50436
Office
Unavailable
Facility
$137.16
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 50436
Office
Unavailable
Facility
$142.98
No comparable office rate is available.
Rest Of Maryland
Maryland · 50436
Office
Unavailable
Facility
$136.63
No comparable office rate is available.
Rest Of Maine
Maine · 50436
Office
Unavailable
Facility
$129.13
No comparable office rate is available.
Southern Maine
Maine · 50436
Office
Unavailable
Facility
$131.66
No comparable office rate is available.
Detroit
Michigan · 50436
Office
Unavailable
Facility
$143.10
No comparable office rate is available.
Rest Of Michigan
Michigan · 50436
Office
Unavailable
Facility
$134.82
No comparable office rate is available.
Minnesota
Minnesota · 50436
Office
Unavailable
Facility
$129.03
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 50436
Office
Unavailable
Facility
$133.93
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 50436
Office
Unavailable
Facility
$134.66
No comparable office rate is available.
Rest Of Missouri
Missouri · 50436
Office
Unavailable
Facility
$131.27
No comparable office rate is available.
Mississippi
Mississippi · 50436
Office
Unavailable
Facility
$128.49
No comparable office rate is available.
Montana**
Montana · 50436
Office
Unavailable
Facility
$136.25
No comparable office rate is available.
North Carolina
North Carolina · 50436
Office
Unavailable
Facility
$129.77
No comparable office rate is available.
North Dakota**
North Dakota · 50436
Office
Unavailable
Facility
$129.33
No comparable office rate is available.
Nebraska
Nebraska · 50436
Office
Unavailable
Facility
$126.38
No comparable office rate is available.
New Hampshire
New Hampshire · 50436
Office
Unavailable
Facility
$136.21
No comparable office rate is available.
Northern Nj
New Jersey · 50436
Office
Unavailable
Facility
$148.22
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 50436
Office
Unavailable
Facility
$144.16
No comparable office rate is available.
New Mexico
New Mexico · 50436
Office
Unavailable
Facility
$135.80
No comparable office rate is available.
Nevada**
Nevada · 50436
Office
Unavailable
Facility
$134.36
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 50436
Office
Unavailable
Facility
$158.53
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 50436
Office
Unavailable
Facility
$146.04
No comparable office rate is available.
Queens
New York · 50436
Office
Unavailable
Facility
$153.44
No comparable office rate is available.
Rest Of New York
New York · 50436
Office
Unavailable
Facility
$131.10
No comparable office rate is available.
Ohio
Ohio · 50436
Office
Unavailable
Facility
$133.41
No comparable office rate is available.
Oklahoma
Oklahoma · 50436
Office
Unavailable
Facility
$130.02
No comparable office rate is available.
Portland
Oregon · 50436
Office
Unavailable
Facility
$138.51
No comparable office rate is available.
Rest Of Oregon
Oregon · 50436
Office
Unavailable
Facility
$132.67
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 50436
Office
Unavailable
Facility
$141.56
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 50436
Office
Unavailable
Facility
$132.84
No comparable office rate is available.
Puerto Rico
Puerto Rico · 50436
Office
Unavailable
Facility
$136.48
No comparable office rate is available.
Rhode Island
Rhode Island · 50436
Office
Unavailable
Facility
$137.86
No comparable office rate is available.
South Carolina
South Carolina · 50436
Office
Unavailable
Facility
$131.93
No comparable office rate is available.
South Dakota**
South Dakota · 50436
Office
Unavailable
Facility
$128.51
No comparable office rate is available.
Austin
Texas · 50436
Office
Unavailable
Facility
$137.10
No comparable office rate is available.
Beaumont
Texas · 50436
Office
Unavailable
Facility
$132.38
No comparable office rate is available.
Brazoria
Texas · 50436
Office
Unavailable
Facility
$134.12
No comparable office rate is available.
Dallas
Texas · 50436
Office
Unavailable
Facility
$135.29
No comparable office rate is available.
Fort Worth
Texas · 50436
Office
Unavailable
Facility
$135.11
No comparable office rate is available.
Galveston
Texas · 50436
Office
Unavailable
Facility
$134.75
No comparable office rate is available.
Houston
Texas · 50436
Office
Unavailable
Facility
$141.16
No comparable office rate is available.
Rest Of Texas
Texas · 50436
Office
Unavailable
Facility
$133.40
No comparable office rate is available.
Utah
Utah · 50436
Office
Unavailable
Facility
$133.04
No comparable office rate is available.
Virginia
Virginia · 50436
Office
Unavailable
Facility
$132.26
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 50436
Office
Unavailable
Facility
$136.48
No comparable office rate is available.
Vermont
Vermont · 50436
Office
Unavailable
Facility
$130.16
No comparable office rate is available.
Rest Of Washington
Washington · 50436
Office
Unavailable
Facility
$136.46
No comparable office rate is available.
Seattle (King Cnty)
Washington · 50436
Office
Unavailable
Facility
$146.40
No comparable office rate is available.
Wisconsin
Wisconsin · 50436
Office
Unavailable
Facility
$126.76
No comparable office rate is available.
West Virginia
West Virginia · 50436
Office
Unavailable
Facility
$136.85
No comparable office rate is available.
Wyoming**
Wyoming · 50436
Office
Unavailable
Facility
$133.24
No comparable office rate is available.
See how rates vary across the country
50436 · 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.
View all state and territory rates as a table
| State / territory | 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 |
Where does this rate apply?
Tennessee is a Medicare payment area. Our Census mapping connects it to 504 cities and communities in Tennessee, 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 50436 in Tennessee. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$140.54
$127.76 × 110% = $140.54
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.
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 50436 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
5,923
- Code
- 50436
- Physician work
- 2.71
- Practice expense
- 1.02
- Malpractice
- 0.35
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.71 | × 1.000 | 2.7100 |
| Practice expense | 1.02 | × 0.909 | 0.9272 |
| Malpractice | 0.35 | × 0.537 | 0.1880 |
| Total RVUs | 3.8251 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$127.76
Open 50436 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.71 | 1 |
| Practice expense | 1.02 | 0.909 |
| Malpractice | 0.35 | 0.537 |
(2.71 × 1 + 1.02 × 0.909 + 0.35 × 0.537) × $33.4009 = $127.76
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
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
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 from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $127.76 | RVU26D |
| 2026-07-01 | Not available in this setting | $127.76 | RVU26C |
| 2026-04-01 | Not available in this setting | $127.76 | RVU26B |
| 2026-01-01 | Not available in this setting | $127.76 | RVU26A |
| 2025-10-01 | Not available in this setting | $136.18 | RVU25D |
| 2025-07-01 | Not available in this setting | $136.18 | RVU25C |
| 2025-04-01 | Not available in this setting | $136.18 | RVU25B |
| 2025-01-01 | Not available in this setting | $136.18 | RVU25A |
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 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.
5,92050433,,Plmt nephroureteral catheter,A,,4.92,26.73,,1.12,,0.53,32.18,6.57,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92150434,,Convert nephrostomy catheter,A,,3.66,21.83,,0.92,,0.41,25.90,4.99,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92250435,,Exchange nephrostomy cath,A,,1.77,14.90,,0.66,,0.20,16.87,2.63,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92350436,,Dilat xst trc ndurlgc px,A,,2.71,1.02,NA,1.02,,0.35,4.08,4.08,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92450437,,Dilat xst trc new access rcs,A,,4.73,1.41,NA,1.41,,0.57,6.71,6.71,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92550500,,Repair of kidney wound,A,,20.69,10.02,NA,10.02,,5.53,36.24,36.24,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,9265050F,,Plan 2 main dr by 1 month,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780