$690.42
Choose 50385 when the existing stent is removed and a replacement is placed. Choose 50386 when the transurethral service removes the stent without replacing it.
On this page
CMS RVU26D · Effective 2026-10-01
50385 Ureteral stent exchange Medicare reimbursement rates in Iowa
Report this service when a urologist removes an existing ureteral stent and places a replacement through the urethra, typically using cystoscopy. Compare 50385 office and facility rates across CMS payment localities in Iowa.
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 50385 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$914.31
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$176.25
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
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.
Urology procedure
About 50385: Transurethral ureteral stent exchange
Report this service when a urologist removes an existing ureteral stent and places a replacement through the urethra, typically using cystoscopy.
A urologist passes a cystoscope through the urethra to reach the bladder and ureteral opening, removes an indwelling ureteral stent, and places a replacement. Fluoroscopy may be used to guide or confirm placement. Exchanges commonly maintain drainage when a stent is due for replacement, becomes obstructed or encrusted, or remains necessary during treatment of stones, ureteral narrowing, or postoperative obstruction. The service is commonly performed in an operating room or ambulatory surgery setting, and may also be performed in an office when appropriate.
Report 50385 for a completed exchange, rather than removal alone or initial stent placement without an existing stent to replace. Documentation should identify the side, indication, existing stent removal, replacement placement, and transurethral approach. Routine cystoscopic access for the exchange is part of the service. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 50385
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.09 · 14%
- Practice expense (office) RVU25.23 · 85%
- Malpractice RVU0.50 · 2%
262
Medicare services in 2024 · #4101 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.
50385 compared with similar codes
Office rates for Iowa, from the same CMS release.
$872.63
Both describe ureteral stent exchange, but 50382 uses a percutaneous route; 50385 uses a transurethral route.
$342.65
52332 is used for placement of an indwelling ureteral stent, rather than exchange of an existing stent through the transurethral route.
Compare 50385 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.
1 of 1 payment localities
Iowa →
Office / nonfacility
$914.31
Facility
$176.25
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 50385 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
5,908
- Code
- 50385
- Physician work
- 4.09
- Practice expense
- 25.23
- Malpractice
- 0.50
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.09 | × 1.000 | 4.0900 |
| Practice expense | 25.23 | × 0.915 | 23.0855 |
| Malpractice | 0.50 | × 0.397 | 0.1985 |
| Total RVUs | 27.3740 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$914.31
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.09 | 1 |
| Practice expense | 25.23 | 0.915 |
| Malpractice | 0.5 | 0.397 |
(4.09 × 1 + 25.23 × 0.915 + 0.5 × 0.397) × $33.4009 = $914.31
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.09 | 1 |
| Practice expense | 1.08 | 0.915 |
| Malpractice | 0.5 | 0.397 |
(4.09 × 1 + 1.08 × 0.915 + 0.5 × 0.397) × $33.4009 = $176.25
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
50385 billing questions
How does 50385 differ from 50386?
50385 represents removal of an existing ureteral stent followed by placement of a replacement. Use 50386 when the stent is removed without an exchange.
When is 50382 more appropriate?
50382 describes a ureteral stent exchange performed percutaneously. 50385 is for an exchange performed through the urethra.
Can routine cystoscopy be billed separately?
Cystoscopic access used to carry out the transurethral exchange is part of 50385. Do not separately report a diagnostic cystoscopy solely for that access.
What documentation supports reporting 50385?
Document the indication and side, the existing stent's removal, placement of the replacement stent, and the transurethral route.
How is bilateral reporting handled?
CMS pays a bilateral service reported with modifier 50 at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others 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 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.
5,90550380,,Rnl autotrnsplj rimpltj kdn,A,,29.36,22.01,NA,22.01,,7.87,59.24,59.24,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,90650382,,Change ureter stent percut,A,,5.12,22.71,,0.80,,0.57,28.40,6.49,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,90750384,,Remove ureter stent percut,A,,4.63,19.38,,0.72,,0.53,24.54,5.88,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,90850385,,Change stent via transureth,A,,4.09,25.23,,1.08,,0.50,29.82,5.67,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,90950386,,Remove stent via transureth,A,,2.97,19.18,,0.96,,0.38,22.53,4.31,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,91050387,,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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136