Billing code 50390: Renal lesion drainageMedicare rate & RVUs in Oregon
Percutaneous needle drainage or injection of a renal cyst or renal pelvis is reported when the clinician treats or evaluates a kidney lesion.
CMS doesn’t publish an office rate for 50390 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 50390 covers
A clinician uses a needle through the skin to aspirate fluid from, or inject material into, a renal cyst or the renal pelvis. The service may be performed by a urologist or interventional radiologist in a procedure room, imaging suite, or hospital setting. A typical clinical reason is evaluating or relieving symptoms from a fluid-filled renal cyst; the target and purpose of the procedure determine whether this code fits.
Report the service for the percutaneous needle procedure, with documentation identifying the renal target, approach, and work performed. This code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and reduces the others. For bilateral reporting with modifier 50, Medicare pays 150%. Medicare does not pay an assistant at surgery for this procedure; co-surgeons and team surgery are 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 50390 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $81.17 |
| Rest Of Oregon | Unavailable | $78.71 |
How the 50390 rate is calculated
Each of 50390’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 · 50390
RVUs × geographic indexes × conversion factor
Work1.91
1.91 RVUs× 1.000 GPCI
Practice expense0.30
0.30 RVUs× 1.000 GPCI
Malpractice0.21
0.21 RVUs× 1.000 GPCI
Adjusted RVUs
2.4200
Conversion factor
$33.4009
Medicare rate
$80.83
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 50390
The CMS indicators that decide how 50390 is paid alongside other services.
CMS payment indicators · 50390
Renal lesion drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
50390 without 50 · national facility
$80.83
Renal lesion drainage
50390-50 · Bilateral: 150%
$121.25
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).
50390 compared with similar codes
Compare codes · National
50390 vs 50391 vs 50396: Medicare rates
How to choose
- 50391Renal instillation
- 50391 is for instilling a therapeutic agent into a renal cyst or pelvis. 50390 describes needle aspiration or injection of the renal target.
- 50396Kidney pressure test
- 50396 measures pressure in the renal pelvis. Choose 50390 when the documented service is needle aspiration or injection, not pressure measurement.
50390 billing questions
How does 50390 differ from 50391?
50390 describes needle aspiration or injection involving a renal cyst or pelvis. Use 50391 when the documented service is instillation of a therapeutic agent into the renal target.
Does 50390 include same-day preoperative and postoperative care?
Yes. Its 0-day global period includes preoperative and postoperative care on the procedure date.
How is bilateral 50390 reported?
Report modifier 50 for a bilateral procedure. Medicare pays the bilateral service at 150% under the CMS rule provided.
What happens when another procedure is performed in the same session?
Medicare pays the highest-valued procedure in full and reduces the other procedure or procedures to 50% under the standard multiple procedure rule.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 50390. Co-surgeons and team surgery are not permitted under the CMS rules provided.
What documentation supports reporting 50390?
Document the renal cyst or pelvis treated, the percutaneous needle approach, and whether aspiration or injection was performed. The record should identify the procedure's clinical purpose.
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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