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CMS RVU26D · Effective 2026-10-01

50520 Fistula closure Medicare reimbursement rates in Oklahoma

Reports surgical closure of an abnormal tract connecting the kidney to the skin, such as a persistent nephrocutaneous fistula. Compare 50520 office and facility rates across CMS payment localities in Oklahoma.

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 50520 in Oklahoma?

Oklahoma 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

$1024.80

1 of 1 localities have a supported rate.

Payment area: Oklahoma

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 50520 in your payment locality →

Urologic surgery

About 50520: Closure of kidney-to-skin fistula

Reports surgical closure of an abnormal tract connecting the kidney to the skin, such as a persistent nephrocutaneous fistula.

This service closes a fistulous tract between the kidney and the skin. A urologist typically performs the operation in a surgical setting when a persistent connection requires operative closure, including a tract that remains after nephrostomy drainage. The surgeon addresses the tract and its openings as needed to eliminate the abnormal communication.

Report 50520 when the documented connection is specifically between kidney and skin; the destination of the tract distinguishes it from closure of a fistula to a viscus. The operative report should establish the kidney-to-skin communication and describe its surgical closure. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 50520

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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
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 RVU18.41 · 56%
  • Practice expense (office) RVU9.47 · 29%
  • Malpractice RVU4.91 · 15%

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.

50520 compared with similar codes

Office rates for Oklahoma, from the same CMS release.

50525

Fistula closure

Kidney-to-viscus fistula

No office rate

This code addresses a fistula involving a viscus. Choose 50520 when the documented tract connects the kidney to the skin.

50526

Fistula closure

With partial nephrectomy

No office rate

This code is also for nephrovisceral fistula closure. The kidney-to-skin connection identifies 50520 instead.

50500

Kidney repair

Wound or injury

No office rate

50500 is for repair of a kidney wound. Use 50520 when the operation closes a fistulous tract from the kidney to the skin.

Compare 50520 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 50520 in Oklahoma.

PPRRVU2026_Oct_nonQPP.csv

5,927

Code
50520
Physician work
18.41
Practice expense
9.47
Malpractice
4.91

GPCI2026.csv

86

Locality
Oklahoma
Physician work
1.000
Practice expense
0.893
Malpractice
0.777
Facility calculation for 50520 in Oklahoma
ComponentRVULocality factorAdjusted
Physician work18.41× 1.00018.4100
Practice expense9.47× 0.8938.4567
Malpractice4.91× 0.7773.8151
Total RVUs30.6818
Conversion factor× 33.4009

Facility rate, Oklahoma$1024.80

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work18.411
Practice expense9.470.893
Malpractice4.910.777

(18.41 × 1 + 9.47 × 0.893 + 4.91 × 0.777) × $33.4009 = $1024.80

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.

50520 billing questions

When should 50520 be selected instead of 50525 or 50526?

Use 50520 for a fistulous connection between the kidney and skin. Codes 50525 and 50526 concern nephrovisceral fistulas, where the connection is to a viscus.

What documentation supports reporting 50520?

The record should identify the kidney-to-skin fistula and describe the operative closure. A skin opening or drainage alone does not establish that connection.

Can modifier 50 be used for bilateral closure?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

How does the 90-day global period affect postoperative care?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 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.

RVUs for 50520PPRRVU2026_Oct_nonQPP.csv, line 5,927 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet