Billing code 50951: UreteroscopyMedicare rate & RVUs in Florida
Reports endoscopic inspection of the ureter for diagnostic evaluation, including an examination with brushing or washing to collect a specimen.
Medicare pays $397.33–$437.25 for 50951 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 50951 covers
A urologist uses a ureteroscope to inspect the ureter when imaging or symptoms require direct evaluation of the urinary passage. The examination may include collecting cells or fluid by brushing or washing. It is a diagnostic service: when the procedure includes a ureteral biopsy or therapeutic work, select the code that describes that work rather than treating this as a diagnostic-only examination. Ureteroscopy is commonly performed in a hospital or ambulatory surgical setting.
Documentation should identify the ureter examined, the diagnostic reason, the findings, and any specimen collection. 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. 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.
Where 50951 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$397.33 to $437.25
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $414.89 | $289.36 |
| Miami | $437.25 | $308.25 |
| Rest Of Florida | $397.33 | $278.87 |
How the 50951 rate is calculated
Each of 50951’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 · 50951
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.68Practice expense 5.37Malpractice 0.72
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 50951
The CMS indicators that decide how 50951 is paid alongside other services.
CMS payment indicators · 50951
Ureteroscopy
| 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
50951 without 50 · national office
$393.13
Ureteroscopy
50951-50 · Bilateral: 150%
$589.70
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).
50951 compared with similar codes
Compare codes
50951 vs 50955 vs 50957 vs 50961: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 50955Ureteroscopy
- Choose 50955 when the ureteroscopic service includes biopsy. This code describes diagnostic inspection, which may include brushing or washing for specimen collection.
- 50957Ureteroscopy
- Choose 50957 when the ureteroscopic service includes treatment. This code is for diagnostic examination rather than therapeutic work.
- 50961Ureteroscopy
- 50961 describes a ureteroscopic treatment service. Use this code when the work is diagnostic inspection without the treatment described by 50961.
50951 billing questions
When should this code be used instead of a ureteroscopy code for biopsy?
Use this code for diagnostic inspection, including brushing or washing to collect a specimen. If tissue is obtained by biopsy, choose the code describing ureteroscopy with biopsy.
Can brushing or washing be part of the diagnostic service?
Yes. Collection of cells or fluid by brushing or washing may accompany the diagnostic examination.
Can this code be reported with a ureteroscopy treatment code in the same session?
When therapeutic work is performed, report the code that describes that work rather than separately reporting a diagnostic examination for the same ureteroscopic service. If separate procedures are performed in one session, the CMS multiple-procedure reduction applies.
How should bilateral ureteroscopic examinations be reported?
For a bilateral procedure, use modifier 50; CMS pays the bilateral service at 150%.
What documentation supports this code?
Record the diagnostic indication, the ureter examined, endoscopic findings, and whether brushing or washing was used to collect a specimen.
Can an assistant or co-surgeon be billed?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this code.
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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