$1,074.85
50387 describes exchange of a nephroureteral catheter; 50382 describes percutaneous exchange of a ureteral stent. Identify the device being exchanged.
On this page
CMS RVU26D · Effective 2026-10-01
50387 Catheter exchange Medicare reimbursement rates in Alaska
Reports percutaneous exchange of a nephroureteral catheter, commonly performed under fluoroscopy when an indwelling catheter requires replacement. Compare 50387 office and facility rates across CMS payment localities in Alaska.
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 50387 in Alaska?
Alaska 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
$575.08
1 of 1 localities have a supported rate.
Payment area: Alaska*
One mapped payment locality.
Facility setting
$98.06
1 of 1 localities have a supported rate.
Payment area: Alaska*
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 procedures
About 50387: Percutaneous nephroureteral catheter exchange
Reports percutaneous exchange of a nephroureteral catheter, commonly performed under fluoroscopy when an indwelling catheter requires replacement.
This service exchanges an indwelling nephroureteral catheter through its percutaneous access tract. The catheter passes from the kidney through the ureter toward the bladder and exits through the skin, unlike a ureteral stent placed entirely inside the urinary tract. An interventional radiologist or urologist commonly performs the exchange in an interventional radiology suite or other procedural setting, often using fluoroscopy to guide the catheter change.
Report the exchange when the existing nephroureteral catheter is replaced, not for removal alone or exchange of a different device type. Documentation should identify the catheter and access route, the reason for exchange, the work performed, and the catheter’s final position. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 pays bilateral procedures at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 50387
- 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
- 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 RVU1.71 · 11%
- Practice expense (office) RVU13.66 · 88%
- Malpractice RVU0.19 · 1%
6.1K
Medicare services in 2024 · #1747 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.
50387 compared with similar codes
Office rates for Alaska, from the same CMS release.
$1,111.60
50385 is for ureteral stent exchange through a transurethral route. 50387 is for percutaneous exchange of a nephroureteral catheter.
$435.37
50389 covers removal of a nephrostomy tube, while 50387 represents exchange of a nephroureteral catheter.
Compare 50387 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
Alaska* →
Office / nonfacility
$575.08
Facility
$98.06
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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 50387 in Alaska*.
PPRRVU2026_Oct_nonQPP.csv
5,910
- Code
- 50387
- Physician work
- 1.71
- Practice expense
- 13.66
- Malpractice
- 0.19
GPCI2026.csv
5
- Locality
- Alaska*
- Physician work
- 1.500
- Practice expense
- 1.065
- Malpractice
- 0.551
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.71 | × 1.500 | 2.5650 |
| Practice expense | 13.66 | × 1.065 | 14.5479 |
| Malpractice | 0.19 | × 0.551 | 0.1047 |
| Total RVUs | 17.2176 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alaska*$575.08
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.71 | 1.5 |
| Practice expense | 13.66 | 1.065 |
| Malpractice | 0.19 | 0.551 |
(1.71 × 1.5 + 13.66 × 1.065 + 0.19 × 0.551) × $33.4009 = $575.08
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.71 | 1.5 |
| Practice expense | 0.25 | 1.065 |
| Malpractice | 0.19 | 0.551 |
(1.71 × 1.5 + 0.25 × 1.065 + 0.19 × 0.551) × $33.4009 = $98.06
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.
50387 billing questions
How does 50387 differ from 50398?
50387 is for exchanging a nephroureteral catheter that extends from the kidney through the ureter toward the bladder. Use 50398 for an exchanged nephrostomy or pyelostomy tube instead.
How does 50387 differ from 50382?
50387 describes exchange of a nephroureteral catheter with a percutaneous external access route. 50382 is for percutaneous exchange of a ureteral stent.
Is fluoroscopic guidance separately reported?
Fluoroscopic guidance used for the catheter exchange is included in the service. Document the imaging used to guide the exchange and confirm catheter position.
Can modifier 50 be used for bilateral exchanges?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document the exchange performed on each side.
What documentation supports reporting an exchange rather than removal?
Record the indwelling catheter, percutaneous route, reason for replacement, exchange steps, and final catheter position. Removal without replacement is a different service.
How are other same-session procedures paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures performed in the same session are paid at 50%.
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.
5,90750384,,Remove ureter stent percut,A,,4.63,19.38,,0.72,,0.53,24.54,5.88,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,90850385,,Change stent via transureth,A,,4.09,25.23,,1.08,,0.50,29.82,5.67,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,90950386,,Remove stent via transureth,A,,2.97,19.18,,0.96,,0.38,22.53,4.31,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,91050387,,Change nephroureteral cath,A,,1.71,13.66,,0.25,,0.19,15.56,2.15,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,91150389,,Remove renal tube w/fluoro,A,,1.07,10.67,,0.18,,0.12,11.86,1.37,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,91250390,,Drainage of kidney lesion,A,,1.91,0.30,NA,0.30,,0.21,2.42,2.42,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,91350391,,Instll rx agnt into rnal tub,A,,1.91,1.66,,0.39,,0.24,3.81,2.54,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609