No office rate
Both describe percutaneous kidney stone treatment; 50081 is for stones larger than 2 cm, while 50080 is for stones up to 2 cm.
On this page
CMS RVU26D · Effective 2026-10-01
50081 Kidney stone removal Medicare reimbursement rates in Washington
Percutaneous nephrolithotomy for renal or pelvic stones larger than 2 cm, reported when the surgeon fragments and removes stones through a kidney access tract. Compare 50081 office and facility rates across CMS payment localities in Washington.
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 50081 in Washington?
Washington 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
$1002.09–$1072.79
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 50081: Complex percutaneous kidney stone removal
Percutaneous nephrolithotomy for renal or pelvic stones larger than 2 cm, reported when the surgeon fragments and removes stones through a kidney access tract.
A urologist uses an access tract through the flank to reach the kidney or renal pelvis, then fragments and removes a stone burden larger than 2 cm. The operation is typically performed in an operating room, often for large or complex renal stones that require percutaneous rather than ureteroscopic treatment. The procedure may involve nephroscopic inspection and stone extraction as well as lithotripsy.
Select this code when the documented stone size exceeds 2 cm; code 50080 is the related choice for stones up to 2 cm. The operative report should establish stone size, location, laterality, the percutaneous approach, and the fragmentation or removal performed. 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 claim, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 identifies bilateral surgery and is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team-surgery billing is not permitted.
CMS billing rules for 50081
- 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 RVU20.39 · 68%
- Practice expense (office) RVU6.99 · 23%
- Malpractice RVU2.61 · 9%
12.2K
Medicare services in 2024 · #1370 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.
50081 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
50075 describes open removal of a large staghorn calculus; 50081 uses a percutaneous access tract for stones larger than 2 cm.
No office rate
50060 is nephrolithotomy for calculus removal by an open approach. Choose 50081 when the surgeon treats a stone larger than 2 cm percutaneously.
No office rate
52356 treats stones through ureteroscopy or pyeloscopy and includes lithotripsy with ureteral stent insertion; 50081 uses percutaneous access to the kidney.
Compare 50081 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
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$1002.09
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$1072.79
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50081 billing questions
When should 50081 be chosen over 50080?
Use 50081 for a stone burden larger than 2 cm treated by the percutaneous approach. Code 50080 is the related code for stones up to 2 cm.
What documentation supports 50081?
Document stone size, kidney or renal-pelvis location, laterality, the percutaneous approach, and the fragmentation or removal performed.
How does the 90-day global period affect billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is bilateral surgery reported?
Report bilateral surgery with 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 billing is not permitted.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and other procedures at 50% when multiple procedures are performed in the same session.
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.
5,87250070,,Nl comp cgen kdn abnormality,A,,21.30,7.63,NA,7.63,,2.74,31.67,31.67,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,87350075,,Nl rmvl lg staghorn calculus,A,,26.41,9.02,NA,9.02,,3.39,38.82,38.82,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,87450080,,Perq nl/pl lithotrp smpl<2cm,A,,12.10,5.16,NA,5.16,,1.56,18.82,18.82,0,090,0.08,0.83,0.09,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,87550081,,Perq nl/pl lithotrp cplx>2cm,A,,20.39,6.99,NA,6.99,,2.61,29.99,29.99,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,87650100,,Trnsxj/repos abrrnt rnl vsls,A,,17.01,9.13,NA,9.13,,4.54,30.68,30.68,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,8775010F,,Macul result phy/qhp mng dm,M,,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
5,87850120,,Pyelotomy w/exploration,A,,16.78,6.61,NA,6.61,,2.16,25.55,25.55,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00