Billing code 50540: Kidney revisionMedicare rate & RVUs in Illinois
Surgical reconstruction of a horseshoe kidney is reported when its congenital fusion or associated renal-pelvis anatomy requires operative revision.
CMS doesn’t publish an office rate for 50540 in Illinois.
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 50540 covers
Code 50540 covers operative revision of a horseshoe kidney, a congenital condition in which the lower renal poles are fused. A urologist typically performs the surgery in an operating room when the fused anatomy or related renal-pelvis anatomy requires correction. The work may involve the isthmus, the renal pelvis, or both. The operative report should identify the horseshoe anatomy and describe the specific reconstruction performed.
Report 50540 for revision of the horseshoe kidney itself, not for an isolated endoscopic stone procedure or a pyeloplasty limited to the ureteropelvic junction. This is major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. The code is priced as bilateral, so modifier 50 does not increase payment. An assistant at surgery may be paid; 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.
Where 50540 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,145.66 |
| East St. Louis | Unavailable | $1,094.81 |
| Rest Of Illinois | Unavailable | $1,053.29 |
| Suburban Chicago | Unavailable | $1,105.05 |
How the 50540 rate is calculated
Each of 50540’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 · 50540
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 20.57Practice expense 7.49Malpractice 2.64
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 50540
50540 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50540
Kidney revision
| 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) | 2 | Already bilateral by definition: paid once at 100%. |
| 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 · 50540
Kidney revision
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 51 · payment effect
With and without the modifier
50540 without 51 · national facility
$1,025.41
Kidney revision
50540-51 · Second procedure: 50%
$512.71
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
50540 compared with similar codes
Compare codes
50540 vs 50400 vs 50405 vs 50544 vs 50500: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 50400Pyeloplasty
- This code describes pyeloplasty without vascular transposition. Choose 50540 when the operation revises the horseshoe kidney anatomy rather than addressing only the ureteropelvic junction.
- 50405Pyeloplasty
- This code describes pyeloplasty with vascular transposition. Code 50540 is for operative revision of horseshoe kidney anatomy.
- 50544Pyeloplasty
- This is laparoscopic pyeloplasty. Use it for laparoscopic junctional reconstruction, not for revision of the horseshoe kidney itself.
- 50500Kidney repair
- This code is for repair of a kidney wound. Code 50540 addresses operative revision of congenital horseshoe kidney anatomy, not wound repair.
50540 billing questions
When is 50540 more appropriate than a pyeloplasty code?
Use 50540 when the operation revises the horseshoe kidney anatomy, including work on the isthmus or renal pelvis. A pyeloplasty code may be considered when the operation is limited to reconstruction of the ureteropelvic junction.
Should modifier 50 be reported for the paired kidneys?
The code is already priced as bilateral. Modifier 50 does not increase payment.
What postoperative care is included in the global period?
The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
What documentation supports reporting 50540?
The operative report should establish the horseshoe kidney anatomy and specify the revision performed, such as work involving the isthmus or renal pelvis.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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