CPT 50840: Ureteral reconstructionMedicare rate & RVUs in Washington
Replaces a damaged or missing ureteral segment with bowel to restore urine flow from the kidney toward the bladder.
CMS doesn’t publish an office rate for 50840 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 50840 covers
This operation uses a segment of bowel, commonly ileum, to bridge a damaged or missing portion of a ureter and carry urine toward the bladder. A urologist performs the reconstruction in an operating room, typically for a long ureteral defect or severe stricture that cannot be managed by a shorter repair. The bowel segment is joined to the urinary tract at each end to restore continuity.
Report the code when the bowel segment substitutes for the ureter, not when a ureter is simply implanted into bowel as a diversion. The operative report should identify the affected side or sides, the defect, the bowel segment, and the reconstruction performed. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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 50840 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,105.48 |
| Seattle (King Cnty) | Unavailable | $1,186.54 |
How the 50840 rate is calculated
Each of 50840’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 · 50840
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 21.83Practice expense 8.40Malpractice 2.81
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 50840
50840 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 50840
Ureteral reconstruction
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 50840
Ureteral reconstruction
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 50 · payment effect
With and without the modifier
50840 without 50 · national facility
$1,103.57
Ureteral reconstruction
50840-50 · Bilateral: 150%
$1,655.36
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
50840 compared with similar codes
Compare codes
50840 vs 50800 vs 50810 vs 50820: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 50800Ureteral implantation
- Choose 50840 when bowel substitutes for a damaged ureteral segment. Code 50800 describes implantation of the ureter into bowel.
- 50810Ureter-bowel connection
- Code 50810 describes a ureter-to-bowel diversion connection; 50840 reconstructs the ureter using bowel as its replacement segment.
- 50820Urinary diversion
- Code 50820 is for urinary diversion through an intestinal conduit. Code 50840 uses bowel to replace a ureteral segment and restore its continuity.
50840 billing questions
How does this differ from implanting a ureter into bowel?
This service uses bowel to replace a ureteral segment and restore the route toward the bladder. Implanting a ureter into bowel is a urinary diversion, not ureter replacement.
What documentation supports reporting this code?
The operative report should describe the ureteral defect, the bowel segment used, the connections made, and the side or sides reconstructed.
How is bilateral ureter replacement reported?
When both ureters are replaced in the same session, report the bilateral procedure with modifier 50. CMS pays the bilateral procedure at 150%.
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?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery 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% under 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 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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