No office rate
Use 50437 when the dilated tract is used to establish new access into the renal collecting system. Use 50436 for dilation of an existing tract without that new access.
On this page
CMS RVU26D · Effective 2026-10-01
50437 Renal access dilation Medicare reimbursement rates in Tennessee
Percutaneous dilation with new access into the renal collecting system is reported to create a route for an endourologic procedure such as stone treatment. Compare 50437 office and facility rates across CMS payment localities in Tennessee.
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 50437 in Tennessee?
Tennessee 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
$211.02
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 procedure
About 50437: Percutaneous renal tract dilation with new access
Percutaneous dilation with new access into the renal collecting system is reported to create a route for an endourologic procedure such as stone treatment.
This service enlarges an existing percutaneous tract and establishes new access into the renal collecting system for an endourologic procedure. A urologist or interventional radiologist may perform it to create a route for percutaneous stone treatment or antegrade endoscopy. Ultrasound and/or fluoroscopy may guide the access and dilation; that guidance is included in the service when performed. The defining feature is new collecting-system access, not dilation of an existing tract alone.
Report 50437 when the operative or procedure note supports both tract dilation and new access into the collecting system. Documentation should identify the existing tract, the new access, the purpose of the route, and the side treated. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 50437
- 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
- 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 RVU4.73 · 70%
- Practice expense (office) RVU1.41 · 21%
- Malpractice RVU0.57 · 8%
2.9K
Medicare services in 2024 · #2194 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.
50437 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$791.96
50432 reports placement of a nephrostomy catheter. 50437 reports tract dilation with new collecting-system access for an endourologic procedure.
$985.40
50433 reports placement of a nephroureteral catheter. 50437 describes dilation and new renal collecting-system access, not catheter placement as its defining service.
Compare 50437 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$211.02
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 50437 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
5,924
- Code
- 50437
- Physician work
- 4.73
- Practice expense
- 1.41
- Malpractice
- 0.57
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.73 | × 1.000 | 4.7300 |
| Practice expense | 1.41 | × 0.909 | 1.2817 |
| Malpractice | 0.57 | × 0.537 | 0.3061 |
| Total RVUs | 6.3178 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$211.02
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.73 | 1 |
| Practice expense | 1.41 | 0.909 |
| Malpractice | 0.57 | 0.537 |
(4.73 × 1 + 1.41 × 0.909 + 0.57 × 0.537) × $33.4009 = $211.02
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.
50437 billing questions
How does 50437 differ from 50436?
50437 includes dilation of an existing tract with new access into the renal collecting system. 50436 describes dilation of an existing tract without that new access.
Is imaging guidance separately reported?
Imaging guidance, such as ultrasound or fluoroscopy, is included when performed as part of 50437.
What documentation supports 50437?
The record should show the existing percutaneous tract, its dilation, and creation of new access into the renal collecting system, including the side and procedural purpose.
How does CMS handle multiple procedures in the same session?
CMS pays the highest-valued procedure in full and other procedures at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. 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.
5,92150434,,Convert nephrostomy catheter,A,,3.66,21.83,,0.92,,0.41,25.90,4.99,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92250435,,Exchange nephrostomy cath,A,,1.77,14.90,,0.66,,0.20,16.87,2.63,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92350436,,Dilat xst trc ndurlgc px,A,,2.71,1.02,NA,1.02,,0.35,4.08,4.08,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92450437,,Dilat xst trc new access rcs,A,,4.73,1.41,NA,1.41,,0.57,6.71,6.71,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92550500,,Repair of kidney wound,A,,20.69,10.02,NA,10.02,,5.53,36.24,36.24,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,9265050F,,Plan 2 main dr by 1 month,I,,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
5,92750520,,Close kidney-skin fistula,A,,18.41,9.47,NA,9.47,,4.91,32.79,32.79,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780