$801.60
50435 exchanges a catheter through an existing percutaneous access tract. 50432 is for placing a nephrostomy catheter through new access.
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CMS RVU26D · Effective 2026-10-01
50435 Nephrostomy exchange Medicare reimbursement rates in Ohio
Report this service when a clinician exchanges an existing percutaneous nephrostomy catheter through its established renal access tract, with imaging guidance. Compare 50435 office and facility rates across CMS payment localities in Ohio.
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 50435 in Ohio?
Ohio 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
$520.23
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$85.98
1 of 1 localities have a supported rate.
Payment area: Ohio
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.
Urinary tract radiology
About 50435: Percutaneous nephrostomy catheter exchange
Report this service when a clinician exchanges an existing percutaneous nephrostomy catheter through its established renal access tract, with imaging guidance.
An interventional radiologist or urologist exchanges a nephrostomy catheter through the patient’s established percutaneous tract into the renal collecting system. The service is used for routine catheter maintenance or when an existing tube is obstructed, damaged, or no longer functioning adequately. Imaging guides the exchange; contrast evaluation of the collecting system or ureter may be performed as part of the service. It is commonly furnished in a hospital or outpatient imaging setting.
Document the existing access, the catheter exchange, the treated side, and the imaging guidance used. When performed during the exchange, the diagnostic nephrostogram or ureterogram and associated imaging are included. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. With modifier 50, a bilateral procedure is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 50435
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.77 · 10%
- Practice expense (office) RVU14.90 · 88%
- Malpractice RVU0.20 · 1%
39.2K
Medicare services in 2024 · #878 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.
50435 compared with similar codes
Office rates for Ohio, from the same CMS release.
$801.76
Choose 50434 for conversion of a nephrostomy catheter to a nephroureteral catheter; choose 50435 for exchange of a nephrostomy catheter.
$572.55
50430 describes an antegrade nephrostogram or ureterogram through existing access. During a 50435 exchange, that diagnostic imaging is included when performed.
Compare 50435 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
Ohio →
Office / nonfacility
$520.23
Facility
$85.98
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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 50435 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
5,922
- Code
- 50435
- Physician work
- 1.77
- Practice expense
- 14.90
- Malpractice
- 0.20
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.77 | × 1.000 | 1.7700 |
| Practice expense | 14.90 | × 0.913 | 13.6037 |
| Malpractice | 0.20 | × 1.008 | 0.2016 |
| Total RVUs | 15.5753 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$520.23
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.77 | 1 |
| Practice expense | 14.9 | 0.913 |
| Malpractice | 0.2 | 1.008 |
(1.77 × 1 + 14.9 × 0.913 + 0.2 × 1.008) × $33.4009 = $520.23
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.77 | 1 |
| Practice expense | 0.66 | 0.913 |
| Malpractice | 0.2 | 1.008 |
(1.77 × 1 + 0.66 × 0.913 + 0.2 × 1.008) × $33.4009 = $85.98
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.
50435 billing questions
How is an exchange different from placing a nephrostomy catheter?
Use 50435 when the clinician exchanges a catheter through an existing percutaneous renal access tract. Placement through new access is represented by 50432.
Can the nephrostogram be billed separately during the exchange?
No. The diagnostic nephrostogram or ureterogram, when performed as part of the exchange, is included in 50435.
When is 50434 more appropriate?
Use 50434 when the existing nephrostomy catheter is converted to a nephroureteral catheter, rather than exchanged for another nephrostomy catheter.
How should bilateral exchanges be reported?
CMS identifies 50435 as a bilateral procedure; report modifier 50 when both sides are treated. The bilateral payment is 150%.
What same-session payment reduction may apply?
When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the others at 50%.
What documentation supports reporting 50435?
Record that a nephrostomy catheter was already present, that it was exchanged through the existing access, the side treated, and the imaging guidance used.
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.
5,91950432,,Plmt nephrostomy catheter,A,,3.90,21.54,,0.99,,0.43,25.87,5.32,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92050433,,Plmt nephroureteral catheter,A,,4.92,26.73,,1.12,,0.53,32.18,6.57,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92150434,,Convert nephrostomy catheter,A,,3.66,21.83,,0.92,,0.41,25.90,4.99,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92250435,,Exchange nephrostomy cath,A,,1.77,14.90,,0.66,,0.20,16.87,2.63,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92350436,,Dilat xst trc ndurlgc px,A,,2.71,1.02,NA,1.02,,0.35,4.08,4.08,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92450437,,Dilat xst trc new access rcs,A,,4.73,1.41,NA,1.41,,0.57,6.71,6.71,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92550500,,Repair of kidney wound,A,,20.69,10.02,NA,10.02,,5.53,36.24,36.24,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703