No office rate
Use 50820 for a continent intestinal reservoir. Use 50825 for diversion through an ileal conduit or sigmoid bladder.
On this page
CMS RVU26D · Effective 2026-10-01
50820 Urinary diversion Medicare reimbursement rates in California
Reports urinary diversion with a continent intestinal reservoir, such as an Indiana pouch, generally created with cystectomy and ureteral implantation. Compare 50820 office and facility rates across CMS payment localities in California.
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 50820 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1169.16–$1341.10
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $171.94 per service.
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.
Where 50820 pays more and less in California
Urologic surgery
About 50820: Continent intestinal urinary diversion
Reports urinary diversion with a continent intestinal reservoir, such as an Indiana pouch, generally created with cystectomy and ureteral implantation.
A urologist constructs a reservoir from bowel to store urine and connects the ureters to it, with a continent outlet that can be emptied by catheterization. An Indiana pouch is a familiar example. The operation is commonly performed in a hospital for patients needing urinary diversion, including after bladder removal for cancer. The service includes cystectomy as part of the diversion when performed; the operative report should identify the reservoir and its continent method of emptying.
Choose this code for a continent intestinal reservoir, not an ileal conduit or sigmoid bladder diversion. Documentation should describe the bowel reservoir, ureteral connections, outlet, and whether cystectomy was performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. A bilateral procedure reported with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 50820
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU23.47 · 67%
- Practice expense (office) RVU8.57 · 24%
- Malpractice RVU3.25 · 9%
820
Medicare services in 2024 · #3122 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.
50820 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
50815 describes urinary diversion with ureterosigmoidostomy; 50820 describes a continent intestinal reservoir, such as an Indiana pouch.
No office rate
50810 is for ureterosigmoidostomy with creation of a sigmoid bladder and bilateral ureteral implantation, not a continent catheterized intestinal reservoir.
Compare 50820 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $1178.65 |
| Chico | Office Unavailable | Facility $1169.16 |
| El Centro | Office Unavailable | Facility $1169.70 |
| Fresno | Office Unavailable | Facility $1169.16 |
| Hanford-Corcoran | Office Unavailable | Facility $1169.16 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1226.77 |
| Madera | Office Unavailable | Facility $1169.16 |
| Merced | Office Unavailable | Facility $1169.16 |
| Modesto | Office Unavailable | Facility $1169.16 |
| Napa | Office Unavailable | Facility $1265.72 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1211.84 |
| Redding | Office Unavailable | Facility $1169.16 |
| Rest Of California | Office Unavailable | Facility $1169.16 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1204.35 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1203.23 |
| Salinas | Office Unavailable | Facility $1198.16 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1208.62 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1311.82 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1308.13 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1341.10 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1326.01 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1181.46 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1206.35 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1197.82 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1217.13 |
| Stockton | Office Unavailable | Facility $1169.16 |
| Vallejo | Office Unavailable | Facility $1260.40 |
| Visalia | Office Unavailable | Facility $1169.16 |
| Yuba City | Office Unavailable | Facility $1169.16 |
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50820 billing questions
How does this differ from 50825?
50820 is for a continent intestinal reservoir, such as an Indiana pouch. 50825 describes a diversion using an ileal conduit or sigmoid bladder.
Is cystectomy included?
Cystectomy is included in the urinary-diversion service when performed as part of the operation. The operative report should establish the diversion and whether the bladder was removed.
Can bowel reconstruction steps be billed separately?
Do not separately report steps integral to creating the same reservoir and urinary diversion. The record should make clear that the reconstruction is a continent intestinal reservoir.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
How are multiple procedures and bilateral reporting handled?
For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. A bilateral procedure reported with modifier 50 is paid at 150%.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; team surgery is 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.
5,98850800,,Implant ureter in bowel,A,,16.00,6.86,NA,6.86,,2.06,24.92,24.92,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,98950810,,Fusion of ureter & bowel,A,,22.04,11.88,NA,11.88,,5.89,39.81,39.81,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99050815,,Urine shunt to intestine,A,,21.70,8.37,NA,8.37,,2.78,32.85,32.85,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99150820,,Construct bowel bladder,A,,23.47,8.57,NA,8.57,,3.25,35.29,35.29,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99250825,,Construct bowel bladder,A,,29.91,10.08,NA,10.08,,3.85,43.84,43.84,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99350830,,Revise urine flow,A,,32.93,10.70,NA,10.70,,4.23,47.86,47.86,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99450840,,Replace ureter by bowel,A,,21.83,8.40,NA,8.40,,2.81,33.04,33.04,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00