No office rate
Choose 50970 for ureteroscopy through a ureterostomy without catheter insertion. Choose 50972 when a ureteral catheter is also inserted.
On this page
CMS RVU26D · Effective 2026-10-01
50972 Ureteroscopy Medicare reimbursement rates in Rhode Island
Reports endoscopic examination of the ureter through a ureterostomy when the urologist also inserts a ureteral catheter. Compare 50972 office and facility rates across CMS payment localities in Rhode Island.
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 50972 in Rhode Island?
Rhode Island 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
$317.44
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Urology
About 50972: Ureteroscopy with ureteral catheter placement
Reports endoscopic examination of the ureter through a ureterostomy when the urologist also inserts a ureteral catheter.
The urologist passes an endoscope through an existing ureterostomy to examine the ureter and inserts a ureteral catheter. The service is used when access is through the stoma rather than the urethra, such as during evaluation or management of a patient with a surgically created ureterostomy. It is performed by a urologist in an operating room or another setting equipped for endoscopic urinary tract procedures.
Select this code when the documented procedure includes both ureteroscopy through the ureterostomy and catheter insertion; a diagnostic examination alone or an added biopsy or treatment belongs to a different code in the family. The operative report should identify the route, ureter examined, catheter placement, and any additional work. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 50972
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
- 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 RVU6.71 · 71%
- Practice expense (office) RVU1.83 · 19%
- Malpractice RVU0.87 · 9%
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.
50972 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
50974 captures ureteroscopy through a ureterostomy with biopsy. 50972 represents catheter insertion without that biopsy service.
No office rate
50976 is for ureteroscopy through a ureterostomy with therapeutic work; 50972 describes catheter insertion as the additional service.
Compare 50972 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$317.44
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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 50972 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
6,011
- Code
- 50972
- Physician work
- 6.71
- Practice expense
- 1.83
- Malpractice
- 0.87
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.71 | × 1.019 | 6.8375 |
| Practice expense | 1.83 | × 1.033 | 1.8904 |
| Malpractice | 0.87 | × 0.892 | 0.7760 |
| Total RVUs | 9.5039 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$317.44
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.71 | 1.019 |
| Practice expense | 1.83 | 1.033 |
| Malpractice | 0.87 | 0.892 |
(6.71 × 1.019 + 1.83 × 1.033 + 0.87 × 0.892) × $33.4009 = $317.44
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.
50972 billing questions
When should I choose 50972 instead of 50970?
Use 50972 when ureteroscopy through a ureterostomy includes insertion of a ureteral catheter. Use 50970 for the endoscopic service without catheter insertion.
Can a biopsy or ureteral treatment be included in 50972?
When the procedure includes biopsy or a separately defined therapeutic service, select the applicable code for that work rather than treating 50972 as a general ureteroscopy code. The operative report should make the work performed clear.
How is bilateral 50972 reported?
Report bilateral performance with modifier 50. CMS pays the bilateral procedure at 150%.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
Can an assistant surgeon be paid for 50972?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are 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 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.
6,00850957,,Ureter endoscopy & treatment,A,,6.61,5.96,,1.86,,0.85,13.42,9.32,0,000,0.00,0.00,0.00,3,1,0,0,0,9,50951,33.4009,09,0,99,0.00,0.00,0.00
6,00950961,,Ureter endoscopy & treatment,A,,5.89,5.48,,1.71,,0.76,12.13,8.36,0,000,0.00,0.00,0.00,3,1,0,0,0,9,50951,33.4009,09,0,99,0.00,0.00,0.00
6,01050970,,Ureter endoscopy,A,,6.95,1.88,NA,1.88,,0.90,9.73,9.73,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,01150972,,Ureter endoscopy & catheter,A,,6.71,1.83,NA,1.83,,0.87,9.41,9.41,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,01250974,,Ureter endoscopy & biopsy,A,,8.93,2.30,NA,2.30,,1.15,12.38,12.38,0,000,0.00,0.00,0.00,3,1,0,0,0,9,50970,33.4009,09,0,99,0.00,0.00,0.00
6,01350976,,Ureter endoscopy & treatment,A,,8.80,2.27,NA,2.27,,1.14,12.21,12.21,0,000,0.00,0.00,0.00,3,1,0,0,0,9,50970,33.4009,09,0,99,0.00,0.00,0.00
6,01450980,,Ureter endoscopy & treatment,A,,6.67,1.82,NA,1.82,,0.86,9.35,9.35,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537