No office rate
Use 50220 for open kidney removal with partial ureterectomy when the procedure does not include the regional lymphadenectomy and/or vena caval thrombectomy that distinguishes 50230.
On this page
CMS RVU26D · Effective 2026-10-01
50230 Radical nephrectomy Medicare reimbursement rates in Guam
Open radical nephrectomy, including partial ureter removal and regional node and/or vena caval thrombus work, for definitive renal surgery. Compare 50230 office and facility rates across CMS payment localities in Guam.
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 50230 in Guam?
Guam 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
No supported rate
Facility setting
$1132.03
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Urologic surgery
About 50230: Open radical nephrectomy with nodal or caval work
Open radical nephrectomy, including partial ureter removal and regional node and/or vena caval thrombus work, for definitive renal surgery.
Code 50230 represents open radical kidney removal with partial removal of the adjacent ureter and regional lymph-node dissection, vena caval tumor-thrombus removal, or both, as indicated. Urologists typically perform it in a hospital operating room for renal malignancy requiring this extent of surgery, such as disease involving regional nodes or extending into the vena cava. It is distinct from limited kidney excision and diagnostic biopsy.
Choose the code based on the operation performed, not the diagnosis alone. The operative report should support the open approach, nephrectomy extent, partial ureter removal, and any regional lymphadenectomy or caval thrombectomy. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made, co-surgeons are permitted, and team surgery is not permitted.
CMS billing rules for 50230
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU23.21 · 68%
- Practice expense (office) RVU7.73 · 23%
- Malpractice RVU3.27 · 10%
1.5K
Medicare services in 2024 · #2679 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.
50230 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
50225 identifies open nephrectomy involving extensive lysis of perirenal adhesions. 50230 is distinguished by regional lymphadenectomy and/or vena caval thrombectomy.
No office rate
Compare the operative extent: 50234 is a kidney-and-ureter removal code, while 50230 describes radical nephrectomy with regional nodal and/or caval thrombus work.
No office rate
50240 is for partial nephrectomy, which removes part of the kidney; 50230 is the radical nephrectomy option with regional nodal and/or caval work.
Compare 50230 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1132.03
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 50230 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
5,887
- Code
- 50230
- Physician work
- 23.21
- Practice expense
- 7.73
- Malpractice
- 3.27
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 23.21 | × 1.000 | 23.2100 |
| Practice expense | 7.73 | × 1.137 | 8.7890 |
| Malpractice | 3.27 | × 0.579 | 1.8933 |
| Total RVUs | 33.8923 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1132.03
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 23.21 | 1 |
| Practice expense | 7.73 | 1.137 |
| Malpractice | 3.27 | 0.579 |
(23.21 × 1 + 7.73 × 1.137 + 3.27 × 0.579) × $33.4009 = $1132.03
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.
50230 billing questions
How does 50230 differ from 50220?
50230 is for open radical nephrectomy with regional lymphadenectomy and/or vena caval thrombectomy. 50220 describes kidney removal with partial ureterectomy without that specified radical nodal or caval work.
What documentation supports 50230?
The operative report should establish the open approach and describe the nephrectomy and partial ureter removal, as well as the regional lymph-node or vena caval work performed.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90.
How is bilateral 50230 paid?
CMS lists this as a bilateral procedure; reporting modifier 50 results in payment at 150% under the stated rule.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made, and co-surgeons are permitted. CMS does not permit team surgery for this code.
What happens when 50230 is performed with other procedures in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures 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.
5,8845020F,,Txmnts 2 phys/qhp by 1 mon,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,88550220,,Remove kidney open,A,,18.21,7.59,NA,7.59,,3.04,28.84,28.84,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,88650225,,Removal kidney open complex,A,,21.33,7.64,NA,7.64,,2.75,31.72,31.72,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,88750230,,Removal kidney open radical,A,,23.21,7.73,NA,7.73,,3.27,34.21,34.21,0,090,0.08,0.83,0.09,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,88850234,,Removal of kidney & ureter,A,,23.45,8.14,NA,8.14,,3.16,34.75,34.75,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,88950236,,Removal of kidney & ureter,A,,26.27,9.50,NA,9.50,,3.37,39.14,39.14,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,89050240,,Nephrectomy partial,A,,23.60,8.87,NA,8.87,,3.18,35.65,35.65,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014