No office rate
Both describe open ureteral stone removal; 50620 is selected for a stone in the middle third rather than the upper third.
On this page
CMS RVU26D · Effective 2026-10-01
50610 Ureteral stone removal Medicare reimbursement rates in Virginia
Reported for open surgical removal of a calculus from the upper one-third of the ureter when the stone’s location and operative approach support this service. Compare 50610 office and facility rates across CMS payment localities in Virginia.
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 50610 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$821.88–$923.07
2 of 2 localities have a supported rate.
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 surgery
About 50610: Upper-third ureteral stone removal
Reported for open surgical removal of a calculus from the upper one-third of the ureter when the stone’s location and operative approach support this service.
A urologist performs an open ureterolithotomy to reach and remove a stone in the upper one-third of the ureter. The operation involves incision into the ureter at the stone site and is typically performed in an operating room when an open approach is selected. This code distinguishes upper-ureter stone removal from procedures for stones in the middle or lower ureter and from endoscopic extraction or fragmentation.
Select the code based on the documented stone location and the operation actually performed, not simply the kidney or ureter diagnosis. The operative report should establish the upper-third location and describe the open ureteral approach and stone removal. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure case, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 50610
- 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 RVU16.82 · 66%
- Practice expense (office) RVU6.37 · 25%
- Malpractice RVU2.16 · 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.
50610 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
Both describe open ureteral stone removal; 50630 is selected for a stone in the lower third rather than the upper third.
No office rate
52352 describes endoscopic ureteral stone extraction without lithotripsy. Use 50610 when the documented procedure is open ureterolithotomy for an upper-third stone.
No office rate
52353 describes endoscopic stone treatment with lithotripsy. It differs from the open ureteral incision and extraction represented by 50610.
Compare 50610 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$923.07
Virginia →
Office / nonfacility
Unavailable
Facility
$821.88
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50610 billing questions
How is 50610 distinguished from 50620 or 50630?
Use 50610 for a stone in the upper one-third of the ureter. Codes 50620 and 50630 describe stone removal in the middle and lower thirds, respectively.
Does 50610 describe ureteroscopic stone extraction?
No. It describes open ureterolithotomy. Endoscopic ureteroscopic extraction or fragmentation is represented by different services, such as 52352 or 52353, when those procedures are performed.
What documentation supports reporting 50610?
The operative report should identify the stone as being in the upper one-third of the ureter and document the open ureteral incision and stone removal.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are bilateral cases and same-session procedures handled?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted for this code.
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.
5,95650605,,Insert ureteral support,A,,16.37,7.79,NA,7.79,,3.86,28.02,28.02,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,95750606,,Endoluminal bx urtr rnl plvs,A,,3.08,10.76,,0.29,,0.40,14.24,3.77,0,ZZZ,0.00,0.00,0.00,0,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,9585060F,,Fndngs mammo 2pt w/in 3 days,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
5,95950610,,Removal of ureter stone,A,,16.82,6.37,NA,6.37,,2.16,25.35,25.35,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,96050620,,Removal of ureter stone,A,,16.02,6.21,NA,6.21,,2.06,24.29,24.29,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,9615062F,,Mammo result com to pt 5 day,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
5,96250630,,Removal of ureter stone,A,,15.80,6.16,NA,6.16,,2.04,24.00,24.00,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00