No office rate
Choose 50920 for a ureter-to-skin fistula and 50930 for a ureter-to-bowel fistula.
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CMS RVU26D · Effective 2026-10-01
50920 Ureteral fistula repair Medicare reimbursement rates in Vermont
Reports operative closure of an abnormal connection between a ureter and the skin, such as a persistent urinary leak through a cutaneous tract. Compare 50920 office and facility rates across CMS payment localities in Vermont.
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 50920 in Vermont?
Vermont 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
$760.13
1 of 1 localities have a supported rate.
Payment area: Vermont
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 50920: Ureterocutaneous fistula closure
Reports operative closure of an abnormal connection between a ureter and the skin, such as a persistent urinary leak through a cutaneous tract.
A urologist uses this service to close a ureterocutaneous fistula, an abnormal passage that allows urine to drain from a ureter through the skin. The operation addresses the communication between the ureter and the skin, rather than a planned urinary opening or a fistula connecting the ureter to bowel. It may be performed to treat persistent urinary drainage through a cutaneous tract after an injury or prior procedure.
Report the code when the operative work is closure of the ureter-to-skin fistula. The operative report should identify the fistula and describe its location and the repair performed. This major surgery has a 90-day global period, including the day before surgery and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 50920
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU15.41 · 65%
- Practice expense (office) RVU6.41 · 27%
- Malpractice RVU1.98 · 8%
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.
50920 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
50900 describes ureter repair without the specific ureter-to-skin fistula closure addressed by 50920.
No office rate
50780 describes connecting a ureter to the bladder. It is a different reconstructive service from closing a ureterocutaneous fistula.
Compare 50920 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
Vermont →
Office / nonfacility
Unavailable
Facility
$760.13
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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 50920 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
5,998
- Code
- 50920
- Physician work
- 15.41
- Practice expense
- 6.41
- Malpractice
- 1.98
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.41 | × 1.000 | 15.4100 |
| Practice expense | 6.41 | × 0.990 | 6.3459 |
| Malpractice | 1.98 | × 0.506 | 1.0019 |
| Total RVUs | 22.7578 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$760.13
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.41 | 1 |
| Practice expense | 6.41 | 0.99 |
| Malpractice | 1.98 | 0.506 |
(15.41 × 1 + 6.41 × 0.99 + 1.98 × 0.506) × $33.4009 = $760.13
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.
50920 billing questions
How is this different from 50930?
50920 is for a fistula between the ureter and skin. 50930 is for a fistula between the ureter and bowel.
When would 50900 be more appropriate?
Use 50900 for ureter repair when the operation is not closure of a ureter-to-skin fistula. The operative report should support the specific repair performed.
Is modifier 50 appropriate for bilateral repair?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard multiple-procedure reduction.
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.
5,99550845,,Appendico-vesicostomy,A,,21.90,9.07,NA,9.07,,2.82,33.79,33.79,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99650860,,Transplant ureter to skin,A,,16.65,6.67,NA,6.67,,2.14,25.46,25.46,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99750900,,Repair of ureter,A,,14.66,6.25,NA,6.25,,1.88,22.79,22.79,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99850920,,Closure ureter/skin fistula,A,,15.41,6.41,NA,6.41,,1.98,23.80,23.80,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99950930,,Closure ureter/bowel fistula,A,,19.69,7.30,NA,7.30,,2.53,29.52,29.52,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,00050940,,Release of ureter,A,,15.53,6.44,NA,6.44,,2.00,23.97,23.97,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,00150945,,Laparoscopy ureterolithotomy,A,,17.52,6.19,NA,6.19,,2.25,25.96,25.96,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817