No office rate
50225 represents a complicated open nephrectomy. Select it only when the operative report supports the added complexity rather than a standard nonradical removal.
On this page
CMS RVU26D · Effective 2026-10-01
50220 Kidney removal Medicare reimbursement rates in Utah
Reports open removal of a kidney, with limited ureteral excision when performed, for disease managed without a more extensive complex or radical operation. Compare 50220 office and facility rates across CMS payment localities in Utah.
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 50220 in Utah?
Utah 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
$937.71
1 of 1 localities have a supported rate.
Payment area: Utah
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.
Urologic surgery
About 50220: Open simple nephrectomy with partial ureterectomy
Reports open removal of a kidney, with limited ureteral excision when performed, for disease managed without a more extensive complex or radical operation.
A urologist typically performs this open operation to remove a diseased or nonfunctioning kidney, sometimes taking a short portion of the ureter with it. A common clinical situation is a chronically obstructed or infected kidney that is no longer functional. The code represents a nonradical nephrectomy; the operation may be performed in a hospital operating room and is distinct from partial kidney removal or a more extensive radical procedure.
Choose the code based on the operative approach and documented extent of removal. The operative report should identify the kidney and side, describe the open removal and any ureteral excision, and establish why the operation was performed and whether its extent was complex or radical. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and additional procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, while team surgery is not permitted.
CMS billing rules for 50220
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU18.21 · 63%
- Practice expense (office) RVU7.59 · 26%
- Malpractice RVU3.04 · 11%
782
Medicare services in 2024 · #3175 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.
50220 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
50230 is for radical nephrectomy. The operative extent, not merely a diagnosis of kidney cancer, distinguishes it from nonradical removal.
No office rate
50234 includes removal of the entire ureter with a bladder cuff through the same incision. This code allows for limited ureteral excision with kidney removal.
No office rate
50240 is used when part of the kidney is removed and functioning renal tissue remains; this code represents complete kidney removal.
Compare 50220 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
Utah →
Office / nonfacility
Unavailable
Facility
$937.71
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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 50220 in Utah.
PPRRVU2026_Oct_nonQPP.csv
5,885
- Code
- 50220
- Physician work
- 18.21
- Practice expense
- 7.59
- Malpractice
- 3.04
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.21 | × 1.000 | 18.2100 |
| Practice expense | 7.59 | × 0.940 | 7.1346 |
| Malpractice | 3.04 | × 0.898 | 2.7299 |
| Total RVUs | 28.0745 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$937.71
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.21 | 1 |
| Practice expense | 7.59 | 0.94 |
| Malpractice | 3.04 | 0.898 |
(18.21 × 1 + 7.59 × 0.94 + 3.04 × 0.898) × $33.4009 = $937.71
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.
50220 billing questions
How is this distinguished from a complex or radical nephrectomy?
Use this code for open nonradical kidney removal. The operative report should support a more complex operation or radical extent before selecting 50225 or 50230, respectively.
Can a portion of the ureter be removed with this procedure?
Yes. Limited ureteral excision may accompany the kidney removal; removal of the entire ureter with a bladder cuff points to a different nephrectomy code.
How should bilateral kidney removal be reported?
For bilateral performance, report modifier 50. CMS payment for the bilateral procedure is 150%.
Are assistant or co-surgeon services payable?
CMS permits assistant-at-surgery payment. Co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How does CMS handle another procedure performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid 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 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.
5,88250200,,Renal biopsy perq,A,,2.32,12.17,,0.74,,0.24,14.73,3.30,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,88350205,,Renal bx surg exposure kdn,A,,11.98,6.39,NA,6.39,,2.98,21.35,21.35,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,8845020F,,Txmnts 2 phys/qhp by 1 mon,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
5,88550220,,Remove kidney open,A,,18.21,7.59,NA,7.59,,3.04,28.84,28.84,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,88650225,,Removal kidney open complex,A,,21.33,7.64,NA,7.64,,2.75,31.72,31.72,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,88750230,,Removal kidney open radical,A,,23.21,7.73,NA,7.73,,3.27,34.21,34.21,0,090,0.08,0.83,0.09,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,88850234,,Removal of kidney & ureter,A,,23.45,8.14,NA,8.14,,3.16,34.75,34.75,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985