No office rate
Use 50610 when the stone is in the upper third of the ureter; 50630 is for the lower third.
On this page
CMS RVU26D · Effective 2026-10-01
50630 Ureteral stone removal Medicare reimbursement rates in Ohio
Reports open surgical removal of a calculus from the lower third of the ureter, selected by the stone’s documented location and operative method. Compare 50630 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 50630 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
No supported rate
Facility setting
$784.27
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.
Urology surgery
About 50630: Lower-third ureteral stone removal
Reports open surgical removal of a calculus from the lower third of the ureter, selected by the stone’s documented location and operative method.
This code represents open ureterolithotomy to remove a stone from the lower, or distal, third of the ureter. A urologist typically performs the operation in a hospital operating room when direct surgical access is used to extract the calculus. The operative report should establish that a ureteral stone was removed and identify its location in the lower third; stones in the upper or middle third belong to different levels in this code family.
Report the code for the lower-third site, not simply because a stone was present somewhere in the ureter. The 90-day global period includes the day-before preoperative visit 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 other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 50630
- 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 RVU15.80 · 66%
- Practice expense (office) RVU6.16 · 26%
- Malpractice RVU2.04 · 9%
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.
50630 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
Use 50620 for a stone in the middle third. The documented site, rather than stone size, separates it from 50630.
No office rate
52352 describes endoscopic ureteroscopic removal or manipulation of a calculus without lithotripsy; 50630 is open removal from the lower third of the ureter.
Compare 50630 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
Unavailable
Facility
$784.27
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 50630 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
5,962
- Code
- 50630
- Physician work
- 15.80
- Practice expense
- 6.16
- Malpractice
- 2.04
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.80 | × 1.000 | 15.8000 |
| Practice expense | 6.16 | × 0.913 | 5.6241 |
| Malpractice | 2.04 | × 1.008 | 2.0563 |
| Total RVUs | 23.4804 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$784.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.8 | 1 |
| Practice expense | 6.16 | 0.913 |
| Malpractice | 2.04 | 1.008 |
(15.8 × 1 + 6.16 × 0.913 + 2.04 × 1.008) × $33.4009 = $784.27
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.
50630 billing questions
How is 50630 distinguished from 50610 or 50620?
Select among these ureterolithotomy codes by the documented location of the stone: 50630 is for the lower third, 50610 for the upper third, and 50620 for the middle third.
When is 50630 preferable to ureteroscopic stone removal?
Use 50630 for open surgical removal from the lower third of the ureter. Ureteroscopic extraction is represented by a different code, such as 52352, when the stone is removed endoscopically.
What documentation supports reporting 50630?
The operative report should describe open ureterolithotomy, removal of the calculus, and its location in the lower third of the ureter.
How does the global period affect postoperative services?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are bilateral procedures and other 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 others are subject to the standard 50% reduction.
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.
5,95950610,,Removal of ureter stone,A,,16.82,6.37,NA,6.37,,2.16,25.35,25.35,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,96050620,,Removal of ureter stone,A,,16.02,6.21,NA,6.21,,2.06,24.29,24.29,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,9615062F,,Mammo result com to pt 5 day,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
5,96250630,,Removal of ureter stone,A,,15.80,6.16,NA,6.16,,2.04,24.00,24.00,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,96350650,,Removal of ureter,A,,18.35,7.04,NA,7.04,,2.49,27.88,27.88,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,96450660,,Removal of ureter,A,,20.49,7.47,NA,7.47,,2.63,30.59,30.59,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,96550684,,Injection for ureter x-ray,A,,0.74,3.02,,0.58,,0.08,3.84,1.40,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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