No office rate
50390 concerns needle aspiration or injection of a renal cyst or pelvis. Choose 50391 when the therapeutic agent is delivered through nephrostomy or nephroureteral catheter access.
On this page
CMS RVU26D · Effective 2026-10-01
50391 Renal instillation Medicare reimbursement rates in Illinois
Reports delivery of a therapeutic agent into the renal pelvis or ureter through nephrostomy access, with radiologic supervision and interpretation included. Compare 50391 office and facility rates across CMS payment localities in Illinois.
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 50391 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
$126.95–$138.36
4 of 4 localities have a supported rate.
Facility setting
$88.22–$95.73
4 of 4 localities have a supported rate.
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.
Where 50391 pays more and less in Illinois
4 payment localities
$126.95 to $138.36
Urology procedure
About 50391: Therapeutic renal pelvis instillation
Reports delivery of a therapeutic agent into the renal pelvis or ureter through nephrostomy access, with radiologic supervision and interpretation included.
This service delivers a therapeutic agent into the renal pelvis or ureter through an established nephrostomy or nephroureteral catheter. A urologist or interventional radiologist may perform it when medication or a chemolytic solution is needed in the upper urinary tract, such as treatment intended to dissolve selected urinary stones. It may occur in a hospital or an appropriately equipped outpatient setting. Radiologic supervision and interpretation are part of the service.
Report the code when the documented treatment is instillation through the specified catheter route, rather than needle aspiration or injection of a renal cyst or pelvis. The record should identify the agent, treatment purpose, access route, and radiologic work. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral performance, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 50391
- 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 · 50%
- Practice expense (office) RVU1.66 · 44%
- Malpractice RVU0.24 · 6%
1.3K
Medicare services in 2024 · #2747 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.
50391 compared with similar codes
Office rates for Illinois, from the same CMS release.
Compare 50391 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
$138.36
Facility
$95.73
East St. Louis →
Office / nonfacility
$130.95
Facility
$91.92
Rest Of Illinois →
Office / nonfacility
$126.95
Facility
$88.22
Suburban Chicago →
Office / nonfacility
$135.39
Facility
$91.83
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.
50391 billing questions
When should this code be used instead of 50390?
Use 50391 for therapeutic delivery through a nephrostomy or nephroureteral catheter. Code 50390 describes percutaneous needle aspiration or injection of a renal cyst or pelvis.
Is radiologic supervision and interpretation separately reported?
No. Radiologic supervision and interpretation are included in this service.
What documentation supports the service?
Document the therapeutic agent, the clinical purpose, delivery through nephrostomy or nephroureteral access, and the associated radiologic work.
How is bilateral performance reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted. Co-surgeons and team surgery are not permitted for this service.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
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.
5,91050387,,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
5,91650405,,Revision of kidney/ureter,A,,25.21,8.78,NA,8.78,,3.24,37.23,37.23,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00