Billing code 50970: Ureter endoscopyMedicare rate & RVUs in Delaware
Reports endoscopic examination of the ureter, with code selection guided by the operative approach and whether biopsy, treatment, or catheter work is performed.
CMS doesn’t publish an office rate for 50970 in Delaware.
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 9 sections
What 50970 covers
A urologist uses an endoscope to inspect the ureter, the passage that carries urine from the kidney to the bladder. The procedure is generally performed in a facility setting, where the operative report identifies the access route and the portion of the ureter examined. The 2024 Medicare volume data show facility services for this code and no office services.
Select the code that matches the documented endoscopic service and any separately described biopsy, treatment, or catheter work; nearby codes distinguish those services. The record should identify the indication, access route, findings, and work completed. This code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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.
50970 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $322.36 |
How the 50970 rate is calculated
Each of 50970’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 · 50970
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.95Practice expense 1.88Malpractice 0.90
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 50970
The CMS indicators that decide how 50970 is paid alongside other services.
CMS payment indicators · 50970
Ureter endoscopy
| 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) | 0 | Not paid without supporting documentation. |
| 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
50970 without 50 · national facility
$324.99
Ureter endoscopy
50970-50 · Bilateral: 150%
$487.49
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).
50970 compared with similar codes
Compare codes
50970 vs 50955 vs 50957 vs 50972: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 50955Ureteroscopy
- Consider this neighboring code when the operative report documents biopsy work during ureter endoscopy; this code represents the endoscopy service specified for 50970.
- 50957Ureteroscopy
- This neighboring code describes ureter endoscopy with treatment work. Distinguish it from 50970 by the procedure actually documented.
- 50972Ureteroscopy
- This code is associated with catheter work during ureter endoscopy. Use the operative details to determine whether that service, rather than the service specified by 50970, was performed.
50970 billing questions
How do I distinguish this code from the nearby endoscopy codes?
Use the operative report to identify the approach and whether the ureter was only examined or additional work was performed. Codes in the nearby family describe services such as biopsy, treatment, or catheter work.
Can I report a biopsy or treatment code with this examination?
Choose the code that represents the documented work performed rather than treating a biopsy or treatment as inherent in an examination. The operative note should specify the additional service.
How is bilateral ureter endoscopy reported under the CMS facts?
For a bilateral procedure, modifier 50 is paid at 150% under the stated CMS rule.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.
What documentation supports assistant-at-surgery payment?
The record must document the medical necessity of the assistant. Co-surgeons and team surgery are not permitted for this code under the stated CMS rules.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the 0-day global period.
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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