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CMS RVU26D · Effective 2026-10-01

50040 Renal drainage Medicare reimbursement rates in Nebraska

Reports open surgical drainage of the kidney through a renal incision, typically when urinary obstruction requires operative drainage and a nephrostomy. Compare 50040 office and facility rates across CMS payment localities in Nebraska.

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 50040 in Nebraska?

Nebraska 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

No supported rate

Facility setting

$772.65

1 of 1 localities have a supported rate.

Payment area: Nebraska

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.

Find 50040 in your payment locality →

Urologic surgery

About 50040: Open renal drainage with nephrostomy

Reports open surgical drainage of the kidney through a renal incision, typically when urinary obstruction requires operative drainage and a nephrostomy.

A urologist surgically opens the kidney to establish drainage, generally leaving a nephrostomy tube to maintain an outlet for urine. This open operation may be performed when obstruction or another condition requires direct operative drainage, such as an infected, obstructed collecting system. It is distinct from placing a drainage catheter through the skin under image guidance and from opening the kidney to explore or remove a calculus.

Report the service when the operative documentation supports open renal incision and drainage, rather than catheter placement alone or a stone-removal procedure. The record should identify the indication, side, operative approach, and drainage performed. CMS assigns a 90-day global period, including the preoperative day 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 the standard 50% reduction. Modifier 50 applies to bilateral procedures, paid at 150%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 50040

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
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU16.26 · 65%
  • Practice expense (office) RVU6.59 · 26%
  • Malpractice RVU2.09 · 8%

27

Medicare services in 2024 · #5741 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.

50040 compared with similar codes

Office rates for Nebraska, from the same CMS release.

50045

Renal exploration

Through kidney incision

No office rate

50040 is for open renal drainage; 50045 is selected when the nephrotomy includes exploration as the operative service.

50060

Kidney stone surgery

Open nephrotomy approach

No office rate

50060 is for open removal of a renal calculus. Choose 50040 when the documented service is open drainage rather than stone extraction.

50020

Abscess drainage

Open approach

No office rate

50020 describes open drainage of a renal or perirenal abscess; 50040 describes open renal drainage through nephrotomy.

Compare 50040 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

Office and facility base rates · shared scale starting at $0

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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 50040 in Nebraska.

PPRRVU2026_Oct_nonQPP.csv

5,867

Code
50040
Physician work
16.26
Practice expense
6.59
Malpractice
2.09

GPCI2026.csv

72

Locality
Nebraska
Physician work
1.000
Practice expense
0.923
Malpractice
0.378
Facility calculation for 50040 in Nebraska
ComponentRVULocality factorAdjusted
Physician work16.26× 1.00016.2600
Practice expense6.59× 0.9236.0826
Malpractice2.09× 0.3780.7900
Total RVUs23.1326
Conversion factor× 33.4009

Facility rate, Nebraska$772.65

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work16.261
Practice expense6.590.923
Malpractice2.090.378

(16.26 × 1 + 6.59 × 0.923 + 2.09 × 0.378) × $33.4009 = $772.65

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.

50040 billing questions

How is this different from percutaneous nephrostomy?

This code represents open operative drainage through a renal incision. Percutaneous nephrostomy code 50392 describes catheter placement through a percutaneous route.

When would 50045 be more appropriate?

Use 50045 when the surgeon performs nephrotomy with exploration rather than drainage as the operative service. The operative report should support the work actually performed.

Can a stone-removal code be reported instead?

When the operation removes a renal calculus, select the applicable stone-removal code, such as 50060, rather than reporting drainage as the primary service.

How should bilateral treatment be reported?

CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document the operative work on both sides.

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 in the session are paid at 50%.

Are assistant or co-surgeon services payable?

Assistant-at-surgery payment is restricted for this code. Co-surgeons are paid only with 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 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.

RVUs for 50040PPRRVU2026_Oct_nonQPP.csv, line 5,867 (RVU26D)
Geographic factors for NebraskaGPCI2026.csv, line 72 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet