Billing code 50546: NephrectomyMedicare rate & RVUs in Illinois
Reports laparoscopic removal of a kidney with partial ureter removal, commonly for a diseased or nonfunctioning kidney when radical or donor nephrectomy is not performed.
CMS doesn’t publish an office rate for 50546 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 50546 covers
A urologist typically performs this operation in a hospital operating room using laparoscopic access to remove the kidney and part of the ureter. It may be selected for a kidney with chronic infection, obstruction, or other disease when removal is indicated but the operative work is not a radical nephrectomy or donor-kidney procurement. The kidney and removed ureteral segment are submitted for examination when clinically indicated.
Select the code from the documented approach and extent of removal. The operative report should establish laparoscopic removal of the kidney and partial ureterectomy, and distinguish that work from partial nephrectomy, radical nephrectomy, or total ureterectomy. This major surgery has a 90-day global period that includes 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 subject to a 50% reduction. 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.
Where 50546 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 | $1,213.54 |
| East St. Louis | Unavailable | $1,157.98 |
| Rest Of Illinois | Unavailable | $1,111.51 |
| Suburban Chicago | Unavailable | $1,167.73 |
How the 50546 rate is calculated
Each of 50546’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 · 50546
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.32Practice expense 8.03Malpractice 2.96
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 50546
50546 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50546
Nephrectomy
| 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 · 50546
Nephrectomy
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
50546 without 50 · national facility
$1,079.18
Nephrectomy
50546-50 · Bilateral: 150%
$1,618.77
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).
50546 compared with similar codes
Compare codes
50546 vs 50543 vs 50545 vs 50548: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 50543Partial nephrectomy
- 50543 is for laparoscopic removal of only part of the kidney. Use 50546 when the entire kidney is removed with partial ureterectomy.
- 50545Radical nephrectomy
- 50545 is for the radical laparoscopic operation. Choose 50546 when the documented procedure is kidney removal with partial ureterectomy rather than radical nephrectomy.
- 50548Nephroureterectomy
- 50548 applies when total ureterectomy accompanies laparoscopic nephrectomy. For partial ureter removal, compare with 50546.
50546 billing questions
How does this differ from laparoscopic radical nephrectomy?
Use 50546 for kidney removal with partial ureterectomy when the operative work is not radical nephrectomy. Code 50545 describes the radical procedure, which has a different extent of removal.
Does this code include the partial ureterectomy?
Yes. The partial ureter removal is part of the service represented by 50546; document the extent in the operative report.
When is 50548 a better choice?
When the laparoscopic nephrectomy includes total ureterectomy, compare the case with 50548. The operative report should make clear how much ureter was removed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How is bilateral performance handled?
For bilateral performance, modifier 50 is paid at 150% under the CMS rule for this code.
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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