CPT code 50526: Fistula closure2026 Medicare rate & RVUs in Washington
Surgical closure of an abnormal connection between the kidney and a visceral organ when treatment also includes partial removal of the kidney.
CMS doesn’t publish an office rate for 50526 in Washington.
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 50526 covers
This operation closes an abnormal passage between the kidney and an adjacent visceral organ, such as a nephrocolic fistula, and includes partial nephrectomy. A urologist typically performs the procedure in an operating room when the fistula and involved kidney tissue require operative treatment. The operative report should establish the connection being closed and document the partial kidney resection performed as part of the repair.
Report 50526 when the nephrovisceral fistula is closed with partial nephrectomy; closure without partial nephrectomy is represented by 50525. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. If 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% multiple-procedure reduction. Bilateral adjustment is inappropriate. CMS permits assistant-at-surgery payment; co-surgeons and team surgery are 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 50526 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,449.97 |
| Seattle (King Cnty) | Unavailable | $1,561.90 |
How the 50526 rate is calculated
Each of 50526’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 · 50526
RVUs × geographic indexes × conversion factor
Work25.65
25.65 RVUs× 1.000 GPCI
Practice expense11.60
11.60 RVUs× 1.000 GPCI
Malpractice6.85
6.85 RVUs× 1.000 GPCI
Adjusted RVUs
44.1000
Conversion factor
$33.4009
Medicare rate
$1,472.98
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 50526
50526 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50526
Fistula closure
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 50526
Fistula closure
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 51 · payment effect
With and without the modifier
50526 without 51 · national facility
$1,472.98
Fistula closure
50526-51 · Second procedure: 50%
$736.49
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
50526 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 50525Fistula closure
- Use 50526 when fistula closure includes partial nephrectomy; 50525 describes nephrovisceral fistula closure without that resection.
- 50520Fistula closure
- 50520 is for a nephrocutaneous fistula, which connects the kidney to the skin. 50526 addresses a connection to a visceral organ and includes partial nephrectomy.
- 50500Kidney repair
- 50500 repairs a kidney wound. It does not describe closure of a nephrovisceral fistula with partial nephrectomy.
50526 billing questions
How does 50526 differ from 50525?
50526 is for closing a nephrovisceral fistula when partial nephrectomy is also performed. Use 50525 for closure without partial nephrectomy.
Can the partial nephrectomy be reported separately?
The partial nephrectomy is part of the service described by 50526. Document the resection and fistula repair in the operative report.
Should modifier 50 be appended for bilateral treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant surgeon be paid?
CMS permits assistant-at-surgery payment for 50526. Co-surgeons and team surgery are not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a 50% 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 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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