Billing code 50957: UreteroscopyMedicare rate & RVUs in Florida
Reports ureteroscopic treatment directed at a ureteral lesion, such as endoscopic fulguration, rather than diagnostic inspection or biopsy alone.
Medicare pays $453.76–$499.81 for 50957 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 50957 covers
A urologist uses a ureteroscope to treat a lesion within the ureter, with the therapeutic work performed endoscopically rather than through an open incision. Fulguration is a typical example of treatment directed at a ureteral lesion. The procedure is generally performed in an operating-room or other procedural facility; the record should identify the lesion and describe the treatment actually carried out.
Select this code when the operative report supports endoscopic treatment, not merely inspection or tissue sampling. Document the treated site, findings, and technique. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies rather than pricing each as an unrelated procedure. For bilateral reporting, 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 50957 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
$453.76 to $499.81
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $473.77 | $335.04 |
| Miami | $499.81 | $357.25 |
| Rest Of Florida | $453.76 | $322.84 |
How the 50957 rate is calculated
Each of 50957’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 · 50957
RVUs × geographic indexes × conversion factor
Work6.61
6.61 RVUs× 1.000 GPCI
Practice expense5.96
5.96 RVUs× 1.000 GPCI
Malpractice0.85
0.85 RVUs× 1.000 GPCI
Adjusted RVUs
13.4200
Conversion factor
$33.4009
Medicare rate
$448.24
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 50957
The CMS indicators that decide how 50957 is paid alongside other services.
CMS payment indicators · 50957
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 | 3 | Endoscopy family rules apply. |
| 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
50957 without 50 · national office
$448.24
Ureteroscopy
50957-50 · Bilateral: 150%
$672.36
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).
50957 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 50955Ureteroscopy
- 50955 represents ureteroscopic biopsy. Choose 50957 when the documented procedure treats a ureteral lesion rather than sampling it alone.
- 50970Ureter endoscopy
- 50970 is for diagnostic ureteroscopy. When the same session proceeds to lesion treatment, report the therapeutic service rather than treating diagnostic inspection as a separate procedure.
- 50961Ureteroscopy
- Both codes are in the ureteroscopic treatment family. Compare the operative details with each code’s full descriptor and report the code that matches the intervention performed.
- 50976Ureteroscopy
- 50976 is another ureteroscopic treatment code. The operative report’s specific treatment and the full code descriptor determine which code fits.
50957 billing questions
When is 50957 preferable to the biopsy code 50955?
Use 50957 when the documented work treats a ureteral lesion endoscopically. Use 50955 when the service is ureteroscopic biopsy rather than lesion treatment.
Can diagnostic ureteroscopy be reported separately with 50957?
The diagnostic inspection that leads to treatment during the same operative session is part of the therapeutic endoscopy. Related endoscopies performed together are subject to CMS endoscopy-family pricing.
How should bilateral treatment be reported?
Report modifier 50 when the procedure is performed bilaterally; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
What documentation supports 50957?
The operative report should identify the ureteral lesion and describe the endoscopic treatment performed, such as fulguration. A report describing inspection or biopsy alone does not support this treatment 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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