No office rate
50045 includes incision into the kidney for exploration. Use 50010 when renal exploration is performed without that nephrotomy.
On this page
CMS RVU26D · Effective 2026-10-01
50045 Renal exploration Medicare reimbursement rates in Missouri
Reports open incision into the kidney for direct exploration when the operation requires inspection of renal tissue or the collecting system. Compare 50045 office and facility rates across CMS payment localities in Missouri.
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 50045 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$807.02–$828.89
3 of 3 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 50045 pays more and less in Missouri
Urology surgery
About 50045: Open nephrotomy with renal exploration
Reports open incision into the kidney for direct exploration when the operation requires inspection of renal tissue or the collecting system.
A urologist performs this open operation by making an incision into the kidney to inspect renal tissue or the collecting system. It is distinct from exploration around the kidney that does not require opening the kidney, and from procedures whose defining work is drainage or removal of a calculus. The service is performed in an operating room, generally in a hospital or other surgical facility.
Report the code when the operative record supports nephrotomy with exploration, rather than simply renal exposure or a more specific procedure such as drainage or stone removal. The record should identify the incision into the kidney and the exploration performed. Medicare assigns a 90-day global period, including the day before surgery and 90 days of related postoperative care. When multiple procedures are performed 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%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 50045
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU16.40 · 65%
- Practice expense (office) RVU6.62 · 26%
- Malpractice RVU2.11 · 8%
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.
50045 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
50040 describes nephrostomy or nephrotomy with drainage. 50045 is for nephrotomy with exploration, not drainage as the defining work.
No office rate
50060 is directed at removal of a renal calculus. 50045 describes exploration through a kidney incision rather than calculus removal.
No office rate
50065 describes a secondary surgical operation for a calculus; 50045 describes nephrotomy with exploration, without that calculus-specific purpose.
Compare 50045 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$824.26
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$828.89
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$807.02
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50045 billing questions
How does this differ from renal exploration without nephrotomy?
Use 50045 when the surgeon incises the kidney and explores it. Code 50010 describes renal exploration without that defining kidney incision.
Should 50045 be reported when the kidney is opened for drainage?
When drainage is the defining work, compare 50040, which describes nephrostomy or nephrotomy with drainage. The operative report should support the service actually performed.
Is stone removal included in this code?
The code describes exploration through a kidney incision, not a procedure defined by calculus removal. For nephrolithotomy, compare the stone-removal codes, including 50060 and 50065.
What postoperative care is included?
Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.
How are bilateral procedures and additional same-session procedures paid?
Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation, and 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 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.
5,86550010,,Renal exploration,A,,11.97,5.70,NA,5.70,,1.53,19.20,19.20,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86650020,,Drg perirnl/renal absc open,A,,17.63,7.53,NA,7.53,,2.27,27.43,27.43,0,090,0.08,0.83,0.09,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86750040,,Nfros nfrot w/drg,A,,16.26,6.59,NA,6.59,,2.09,24.94,24.94,0,090,0.08,0.83,0.09,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86850045,,Nephrotomy w/exploration,A,,16.40,6.62,NA,6.62,,2.11,25.13,25.13,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,8695005F,,Pt counsld on exam for moles,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,87050060,,Nl removal calculus,A,,20.43,7.46,NA,7.46,,2.62,30.51,30.51,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,87150065,,Nl sec surg operj calculus,A,,21.76,7.73,NA,7.73,,2.79,32.28,32.28,0,090,0.08,0.83,0.09,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00