$131.48
50391 is for instilling a therapeutic agent into a renal cyst or pelvis. 50390 describes needle aspiration or injection of the renal target.
On this page
CMS RVU26D · Effective 2026-10-01
50390 Renal lesion drainage Medicare reimbursement rates in Guam
Percutaneous needle drainage or injection of a renal cyst or renal pelvis is reported when the clinician treats or evaluates a kidney lesion. Compare 50390 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 50390 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
$79.25
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.
Urology procedure
About 50390: Percutaneous renal cyst or pelvis drainage
Percutaneous needle drainage or injection of a renal cyst or renal pelvis is reported when the clinician treats or evaluates a kidney lesion.
A clinician uses a needle through the skin to aspirate fluid from, or inject material into, a renal cyst or the renal pelvis. The service may be performed by a urologist or interventional radiologist in a procedure room, imaging suite, or hospital setting. A typical clinical reason is evaluating or relieving symptoms from a fluid-filled renal cyst; the target and purpose of the procedure determine whether this code fits.
Report the service for the percutaneous needle procedure, with documentation identifying the renal target, approach, and work performed. This code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and reduces the others. For bilateral reporting with modifier 50, Medicare pays 150%. Medicare does not pay an assistant at surgery for this procedure; co-surgeons and team surgery are not permitted.
CMS billing rules for 50390
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.91 · 79%
- Practice expense (office) RVU0.30 · 12%
- Malpractice RVU0.21 · 9%
1.2K
Medicare services in 2024 · #2828 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.
50390 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
50396 measures pressure in the renal pelvis. Choose 50390 when the documented service is needle aspiration or injection, not pressure measurement.
Compare 50390 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
$79.25
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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 50390 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
5,912
- Code
- 50390
- Physician work
- 1.91
- Practice expense
- 0.30
- Malpractice
- 0.21
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.91 | × 1.000 | 1.9100 |
| Practice expense | 0.30 | × 1.137 | 0.3411 |
| Malpractice | 0.21 | × 0.579 | 0.1216 |
| Total RVUs | 2.3727 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$79.25
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.91 | 1 |
| Practice expense | 0.3 | 1.137 |
| Malpractice | 0.21 | 0.579 |
(1.91 × 1 + 0.3 × 1.137 + 0.21 × 0.579) × $33.4009 = $79.25
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.
50390 billing questions
How does 50390 differ from 50391?
50390 describes needle aspiration or injection involving a renal cyst or pelvis. Use 50391 when the documented service is instillation of a therapeutic agent into the renal target.
Does 50390 include same-day preoperative and postoperative care?
Yes. Its 0-day global period includes preoperative and postoperative care on the procedure date.
How is bilateral 50390 reported?
Report modifier 50 for a bilateral procedure. Medicare pays the bilateral service at 150% under the CMS rule provided.
What happens when another procedure is performed in the same session?
Medicare pays the highest-valued procedure in full and reduces the other procedure or procedures to 50% under the standard multiple procedure rule.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 50390. Co-surgeons and team surgery are not permitted under the CMS rules provided.
What documentation supports reporting 50390?
Document the renal cyst or pelvis treated, the percutaneous needle approach, and whether aspiration or injection was performed. The record should identify the procedure's clinical purpose.
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.
5,90950386,,Remove stent via transureth,A,,2.97,19.18,,0.96,,0.38,22.53,4.31,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,91050387,,Change nephroureteral cath,A,,1.71,13.66,,0.25,,0.19,15.56,2.15,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,91150389,,Remove renal tube w/fluoro,A,,1.07,10.67,,0.18,,0.12,11.86,1.37,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,91250390,,Drainage of kidney lesion,A,,1.91,0.30,NA,0.30,,0.21,2.42,2.42,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,91350391,,Instll rx agnt into rnal tub,A,,1.91,1.66,,0.39,,0.24,3.81,2.54,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,91450396,,Measure kidney pressure,A,,2.04,0.76,NA,0.76,,0.20,3.00,3.00,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,91550400,,Revision of kidney/ureter,A,,20.74,7.52,NA,7.52,,2.67,30.93,30.93,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,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