Billing code 50040: Renal drainageMedicare rate & RVUs in Oregon
Reports open surgical drainage of the kidney through a renal incision, typically when urinary obstruction requires operative drainage and a nephrostomy.
CMS doesn’t publish an office rate for 50040 in Oregon.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 50040 covers
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.
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.
Where 50040 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $848.27 |
| Rest Of Oregon | Unavailable | $811.41 |
How the 50040 rate is calculated
Each of 50040’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 50040
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 16.26Practice expense 6.59Malpractice 2.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 50040
50040 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50040
Renal drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 50040
Renal drainage
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
50040 without 50 · national facility
$833.02
Renal drainage
50040-50 · Bilateral: 150%
$1,249.53
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
50040 compared with similar codes
Compare codes
50040 vs 50045 vs 50060 vs 50020: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 50045Renal exploration
- 50040 is for open renal drainage; 50045 is selected when the nephrotomy includes exploration as the operative service.
- 50060Kidney stone surgery
- 50060 is for open removal of a renal calculus. Choose 50040 when the documented service is open drainage rather than stone extraction.
- 50020Abscess drainage
- 50020 describes open drainage of a renal or perirenal abscess; 50040 describes open renal drainage through nephrotomy.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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