No office rate
Both codes concern operative removal of a ureteral calculus. Choose based on the exact procedure documented and the distinctions in the full code descriptors, not just the presence of a ureteral stone.
On this page
CMS RVU26D · Effective 2026-10-01
51065 Ureteral stone removal Medicare reimbursement rates in Oregon
Reports operative removal of a ureteral calculus when the surgeon performs a ureterolithotomy rather than endoscopic extraction or stone fragmentation. Compare 51065 office and facility rates across CMS payment localities in Oregon.
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 51065 in Oregon?
Oregon has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$517.01–$542.81
2 of 2 localities have a supported rate.
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.
Urologic surgery
About 51065: Operative ureteral calculus removal
Reports operative removal of a ureteral calculus when the surgeon performs a ureterolithotomy rather than endoscopic extraction or stone fragmentation.
A urologist performs an operative ureterolithotomy to remove a calculus lodged in the ureter. The service addresses a ureteral stone requiring surgical access and removal, rather than a stone in the bladder or one treated by endoscopic extraction or fragmentation. It is generally performed in a hospital operating room or another surgical facility.
Report the code when the operative note supports removal of a ureteral calculus by the procedure represented by this code. Document the stone’s ureteral location, the operative approach, and the work performed to remove it; distinguish the service from endoscopic ureteroscopic treatment and bladder stone removal. This is major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 51065
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.70 · 61%
- Practice expense (office) RVU4.92 · 31%
- Malpractice RVU1.25 · 8%
24
Medicare services in 2024 · #5819 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.
51065 compared with similar codes
Office rates for Oregon, from the same CMS release.
No office rate
Use 51050 for a bladder calculus. This code is for a calculus located in the ureter.
No office rate
Use 52352 when the surgeon extracts the stone through a ureteroscopic or pyeloscopic approach; this code represents operative ureteral stone removal.
No office rate
Use 52353 for endoscopic fragmentation of a ureteral or renal calculus. This code represents operative removal rather than endoscopic fragmentation.
Compare 51065 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.
2 of 2 payment localities
Portland →
Office / nonfacility
Unavailable
Facility
$542.81
Rest Of Oregon →
Office / nonfacility
Unavailable
Facility
$517.01
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51065 billing questions
How does this differ from ureteroscopic stone removal?
This code represents operative ureteral stone removal. Use an endoscopic ureteroscopy code when the surgeon accesses and treats the stone endoscopically instead.
Can bladder stone removal be reported instead?
No. Code 51050 is for a calculus in the bladder; this code concerns a calculus in the ureter.
Is modifier 50 appropriate for stones on both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure 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.
6,01851045,,Incise bladder/drain ureter,A,,7.61,4.84,NA,4.84,,1.22,13.67,13.67,0,090,0.08,0.83,0.09,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,01951050,,Removal of bladder stone,A,,7.77,4.21,NA,4.21,,1.01,12.99,12.99,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,02051060,,Removal of ureter stone,A,,9.70,5.01,NA,5.01,,1.25,15.96,15.96,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,02151065,,Remove ureter calculus,A,,9.70,4.92,NA,4.92,,1.25,15.87,15.87,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,02251080,,Drainage of bladder abscess,A,,6.54,3.96,NA,3.96,,0.84,11.34,11.34,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,02351100,,Drain bladder by needle,A,,0.76,1.38,,0.16,,0.09,2.23,1.01,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,02451101,,Drain bladder by trocar/cath,A,,0.99,3.55,,0.21,,0.13,4.67,1.33,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00