No office rate
Use 50080 for a relatively simple percutaneous case with stone burden up to 2 cm. Use 50081 for a larger stone or a complex procedure.
On this page
CMS RVU26D · Effective 2026-10-01
50080 Percutaneous stone removal Medicare reimbursement rates in Pennsylvania
Reports percutaneous removal or fragmentation of a relatively simple kidney or renal pelvis stone up to 2 cm through an access tract created through the flank. Compare 50080 office and facility rates across CMS payment localities in Pennsylvania.
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 50080 in Pennsylvania?
Pennsylvania 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
$611.61–$653.00
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.
Urology surgery
About 50080: Percutaneous removal of small renal stone
Reports percutaneous removal or fragmentation of a relatively simple kidney or renal pelvis stone up to 2 cm through an access tract created through the flank.
A urologist uses a percutaneous tract through the flank to reach a kidney or renal pelvis stone and fragment or remove it. This code describes the simpler procedure for stone burden up to 2 cm, such as a small stone in a renal calyx or renal pelvis. The service is typically performed in an operating room, most often in a hospital facility.
Choose the code based on stone size and procedural complexity, not simply the number of fragments removed. The operative report should support the stone’s size and location, the percutaneous approach, and the work performed; larger or complex cases are distinguished from this service. Medicare applies a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 for a bilateral procedure is paid at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 50080
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.10 · 64%
- Practice expense (office) RVU5.16 · 27%
- Malpractice RVU1.56 · 8%
1.6K
Medicare services in 2024 · #2630 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.
50080 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
50060 describes nephrolithotomy by a different approach. 50080 specifically involves percutaneous access to the kidney or renal pelvis.
No office rate
52356 treats a stone through ureteroscopic access and includes ureteral stent placement. 50080 reaches the kidney or renal pelvis through a percutaneous tract.
Compare 50080 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
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$653.00
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$611.61
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50080 billing questions
How is 50080 distinguished from 50081?
50080 is for a relatively simple percutaneous case with stone burden up to 2 cm. Use 50081 for a larger stone or a complex case.
Can stone fragmentation be billed separately?
Fragmentation and removal are part of the percutaneous stone procedure. Do not report them as separate services for the same work.
Does the number of stones determine the code?
No. Select the level using stone size and procedural complexity, supported by the operative report, rather than counting fragments or stones alone.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care. The procedure’s related routine care is not separately reported during that period.
How is a bilateral procedure reported?
For a bilateral procedure reported with modifier 50, Medicare pays 150% under the stated rule.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons and team surgery are not permitted for this code.
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.
5,87150065,,Nl sec surg operj calculus,A,,21.76,7.73,NA,7.73,,2.79,32.28,32.28,0,090,0.08,0.83,0.09,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,87250070,,Nl comp cgen kdn abnormality,A,,21.30,7.63,NA,7.63,,2.74,31.67,31.67,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,87350075,,Nl rmvl lg staghorn calculus,A,,26.41,9.02,NA,9.02,,3.39,38.82,38.82,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,87450080,,Perq nl/pl lithotrp smpl<2cm,A,,12.10,5.16,NA,5.16,,1.56,18.82,18.82,0,090,0.08,0.83,0.09,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,87550081,,Perq nl/pl lithotrp cplx>2cm,A,,20.39,6.99,NA,6.99,,2.61,29.99,29.99,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,87650100,,Trnsxj/repos abrrnt rnl vsls,A,,17.01,9.13,NA,9.13,,4.54,30.68,30.68,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,8775010F,,Macul result phy/qhp mng dm,M,,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