Billing code 50690: Ureteral injectionMedicare rate & RVUs in Washington
Report this service for injecting contrast through a ureteral catheter to opacify the ureter or collecting system for a retrograde urinary tract study.
Medicare pays $120.42–$135.12 for 50690 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
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 50690 covers
A urologist injects contrast through a ureteral catheter to outline the ureter and, when needed, the renal collecting system on X-ray. The injection may be performed during an operative or endoscopic encounter to assess anatomy or investigate a suspected narrowing, obstruction, or filling defect. This code represents the injection procedure, not the radiologist’s interpretation of the images.
Select 50690 when the documented service is injection through a ureteral catheter for retrograde ureterography or ureteropyelography. The record should identify the access route, contrast injection, and study performed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 50690 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $120.42 | $62.74 |
| Seattle (King Cnty) | $135.12 | $67.90 |
How the 50690 rate is calculated
Each of 50690’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 · 50690
RVUs × geographic indexes × conversion factor
Work1.13
1.13 RVUs× 1.000 GPCI
Practice expense2.25
2.25 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
3.5000
Conversion factor
$33.4009
Medicare rate
$116.90
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 50690
The CMS indicators that decide how 50690 is paid alongside other services.
CMS payment indicators · 50690
Ureteral injection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
50690 without 51 · national office
$116.90
Ureteral injection
50690-51 · Second procedure: 50%
$58.45
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%).
50690 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 50684Ureteral imaging
- Choose 50690 for injection through a ureteral catheter. Choose 50684 for an antegrade study using existing nephrostomy access.
- 52005Ureteral catheterization
- 52005 describes cystourethroscopy with ureteral catheterization and may include instillation or ureteropyelography. 50690 describes the injection procedure through a ureteral catheter, not the cystoscopic catheterization service.
- 74420Retrograde urography
- 74420 covers radiological supervision and interpretation of retrograde urography; 50690 covers the contrast injection procedure.
50690 billing questions
How does 50690 differ from 50684?
50690 describes contrast injection through a ureteral catheter for a retrograde study. 50684 is for an antegrade nephrostogram or ureterogram through existing access.
Does 50690 include the image interpretation?
No. 50690 represents the injection procedure; 74420 describes radiological supervision and interpretation for retrograde urography when that service is performed and documented.
Can 50690 be reported with 52005?
52005 describes cystourethroscopy with ureteral catheterization and may include instillation or ureteropyelography. Do not use 50690 as a substitute for that cystoscopic service or separately report the same work without support for distinct services.
Can modifier 50 be used when both ureters are studied?
No. CMS identifies bilateral adjustment as inapplicable to 50690, so modifier 50 is not appropriate.
How does the multiple-procedure reduction affect 50690?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 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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