Billing code 50845: Bladder channelMedicare rate & RVUs in Illinois
Creation of an appendix-based channel from the bladder to the abdominal wall, typically allowing a patient with difficult urethral access to catheterize and empty the bladder.
CMS doesn’t publish an office rate for 50845 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 50845 covers
The surgeon uses the appendix to form a channel between the bladder and an abdominal opening that can be catheterized to drain urine. Urologists, including pediatric urologists, commonly perform this reconstruction for patients with neurogenic bladder or congenital urinary tract conditions who need a reliable catheterization route but cannot readily catheterize through the urethra. The procedure is performed in an operating room and may be part of a broader urinary reconstruction.
Report 50845 when the operative work creates this appendiceal channel; document the channel’s construction and its connection to the bladder and abdominal wall. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. If another separately reportable procedure is performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. 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 50845 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 | $1,257.23 |
| East St. Louis | Unavailable | $1,199.89 |
| Rest Of Illinois | Unavailable | $1,155.29 |
| Suburban Chicago | Unavailable | $1,214.63 |
How the 50845 rate is calculated
Each of 50845’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 · 50845
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.90Practice expense 9.07Malpractice 2.82
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 50845
50845 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50845
Bladder channel
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 50845
Bladder channel
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
50845 without 51 · national facility
$1,128.62
Bladder channel
50845-51 · Second procedure: 50%
$564.31
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%).
50845 compared with similar codes
Compare codes
50845 vs 50825 vs 50820 vs 50860: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 50825Urinary diversion
- Use 50845 for the appendix-based channel from bladder to abdominal wall. Code 50825 describes a bowel-based continent urinary diversion, not that channel.
- 50820Urinary diversion
- Code 50820 describes an ileal conduit for urinary drainage. Code 50845 creates a catheterizable route that connects the bladder to an abdominal opening.
- 50860Ureterostomy
- Code 50860 routes a ureter to the skin. Code 50845 uses the appendix to create access for catheterizing and emptying the bladder.
50845 billing questions
How is 50845 different from a continent urinary diversion?
50845 describes a catheterizable channel made using the appendix to connect the bladder with an abdominal opening. A bowel-based continent diversion involves a different reconstruction and should be selected according to the anatomy and work documented.
Is bladder augmentation included in 50845?
The code describes creation of the appendiceal catheterization channel, not bladder enlargement. If augmentation is also performed, document that distinct work and determine separate reporting under the applicable coding edits.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
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 services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.
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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