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 Nephrostomy tract dilation Medicare reimbursement rates in Alabama
Report this service when a clinician enlarges an established percutaneous nephrostomy tract to provide access for an endourologic procedure. Compare 50436 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 50436 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$126.94
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
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 Alabama, from the same CMS release.
$767.92
Use 50432 for percutaneous placement of a nephrostomy catheter. Use 50436 when the service is enlargement of an established nephrostomy tract for endourologic access.
$498.36
Use 50435 for exchange of a nephrostomy catheter. Code 50436 describes dilation of the tract to permit endourologic access, not routine catheter exchange.
Compare 50436 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$126.94
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 Alabama.
PPRRVU2026_Oct_nonQPP.csv
5,923
- Code
- 50436
- Physician work
- 2.71
- Practice expense
- 1.02
- Malpractice
- 0.35
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.71 | × 1.000 | 2.7100 |
| Practice expense | 1.02 | × 0.875 | 0.8925 |
| Malpractice | 0.35 | × 0.566 | 0.1981 |
| Total RVUs | 3.8006 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$126.94
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.71 | 1 |
| Practice expense | 1.02 | 0.875 |
| Malpractice | 0.35 | 0.566 |
(2.71 × 1 + 1.02 × 0.875 + 0.35 × 0.566) × $33.4009 = $126.94
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.
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
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515