Billing code 50120: PyelotomyMedicare rate & RVUs in Texas
Reports an open incision into the renal pelvis for surgical exploration when the documented procedure does not include the separately defined work of calculus removal or pyelostomy drainage.
CMS doesn’t publish an office rate for 50120 in Texas.
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 50120 covers
A urologist opens the renal pelvis to inspect the collecting system directly. The operation may be performed when surgical access and exploration of the pelvis are needed, but the operative report does not describe the specific additional work represented by pyelostomy drainage or calculus removal. This is an operative service, generally performed in a hospital or other surgical facility.
Report 50120 when the documented procedure is pyelotomy with exploration. The operative report should identify the renal pelvis incision and the exploration performed; use the more specific code when the procedure includes drainage through a pyelostomy or removal of a calculus. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 50120 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $859.09 |
| Beaumont | Unavailable | $828.40 |
| Brazoria | Unavailable | $840.02 |
| Dallas | Unavailable | $847.31 |
| Fort Worth | Unavailable | $846.04 |
| Galveston | Unavailable | $843.92 |
| Houston | Unavailable | $883.46 |
| Rest Of Texas | Unavailable | $835.14 |
How the 50120 rate is calculated
Each of 50120’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 · 50120
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 16.78Practice expense 6.61Malpractice 2.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 50120
50120 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50120
Pyelotomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 50120
Pyelotomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
50120 without 50 · national facility
$853.39
Pyelotomy
50120-50 · Bilateral: 150%
$1,280.09
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).
50120 compared with similar codes
Compare codes
50120 vs 50125 vs 50130: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 50125Pyelotomy
- Choose 50125 when the pyelotomy includes drainage through a pyelostomy. 50120 describes exploration without that specified drainage procedure.
- 50130Stone removal
- Choose 50130 when a calculus is removed through the pyelotomy. 50120 describes exploration without the specified calculus-removal work.
50120 billing questions
When should 50120 be chosen over 50130?
Use 50120 for pyelotomy with exploration. When the surgeon removes a calculus through the pyelotomy, 50130 describes that more specific procedure.
How does 50120 differ from 50125?
50125 describes pyelotomy with drainage through a pyelostomy. Report 50120 when the documented work is exploration rather than that drainage procedure.
What should the operative report document?
It should establish that the surgeon incised the renal pelvis and explored it. It should also clarify whether the procedure included calculus removal, pyelostomy drainage, or reconstructive work.
How is bilateral 50120 reported?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What payment rules affect other procedures performed in the same session?
Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and the other procedures at 50%.
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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