CPT code 50650: Ureterectomy2026 Medicare rate & RVUs in Guam
Reports surgical removal of the ureter with its bladder cuff when the operative plan requires complete ureter removal rather than stone extraction or exploration.
CMS doesn’t publish an office rate for 50650 in Guam.
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 50650 covers
A urologist removes the ureter along its course together with the portion of bladder attached to its lower end. This is a major operative service performed in a surgical setting, often for ureteral disease requiring complete excision, including urothelial malignancy. The removed tissue is submitted for pathologic examination. The operative report should establish that the ureter and bladder cuff were removed, rather than describing only a ureteral segment or a stone procedure.
Report 50650 when the documented work is complete ureter removal with a bladder cuff. If the operation also removes the kidney, compare the applicable nephrectomy-with-ureterectomy code instead. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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.
50650 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $928.42 |
How the 50650 rate is calculated
Each of 50650’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 · 50650
RVUs × geographic indexes × conversion factor
Work18.35
18.35 RVUs× 1.000 GPCI
Practice expense7.04
7.04 RVUs× 1.000 GPCI
Malpractice2.49
2.49 RVUs× 1.000 GPCI
Adjusted RVUs
27.8800
Conversion factor
$33.4009
Medicare rate
$931.22
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 50650
50650 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50650
Ureterectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 50650
Ureterectomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
50650 without 50 · national facility
$931.22
Ureterectomy
50650-50 · Bilateral: 150%
$1,396.83
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).
50650 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 50234Kidney and ureter removal
- Use 50234 when the operative service includes nephrectomy and total ureter removal with bladder cuff through the same incision; 50650 describes ureter removal without the nephrectomy service.
- 50236Kidney and ureter removal
- 50236 includes nephrectomy with total ureter removal and bladder cuff through separate incisions. Select 50650 when the documented service is ureterectomy with cuff rather than that combined nephrectomy procedure.
- 50548Nephroureterectomy
- 50548 describes laparoscopic nephrectomy with total ureter removal. 50650 is the ureterectomy code when the kidney is not part of the removal.
- 50630Ureteral stone removal
- 50630 describes removal of a stone from the lower third of the ureter. It does not represent excision of the ureter with a bladder cuff.
50650 billing questions
How is 50650 different from ureterolithotomy?
50650 removes the ureter with a bladder cuff. Ureterolithotomy codes describe removal of a ureteral stone, with the code selected by the stone's ureteral location.
Is the bladder cuff included in 50650?
Yes. The cuff is part of the described removal; it is not a separate service under this code.
Can 50650 be reported with nephrectomy?
When the kidney is also removed as part of the nephroureterectomy, compare codes that include nephrectomy and total ureter removal, such as 50234, 50236, or 50548, as applicable to the documented procedure.
What documentation supports 50650?
The operative report should identify removal of the ureter in its entirety and removal of the bladder cuff. A report limited to exploration, a ureteral segment, or stone extraction supports a different service.
How does Medicare handle bilateral 50650?
CMS lists this as a bilateral procedure: when both sides are treated and modifier 50 is reported, payment is at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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