$450.71–$494.59
50955 represents ureteroscopic biopsy. Choose 50957 when the documented procedure treats a ureteral lesion rather than sampling it alone.
On this page
CMS RVU26D · Effective 2026-10-01
50957 Ureteroscopy Medicare reimbursement rates in Washington
Reports ureteroscopic treatment directed at a ureteral lesion, such as endoscopic fulguration, rather than diagnostic inspection or biopsy alone. Compare 50957 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 50957 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
$454.88–$499.27
2 of 2 localities have a supported rate.
Facility setting
$310.67–$331.24
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 procedure
About 50957: Ureteroscopic treatment of a ureteral lesion
Reports ureteroscopic treatment directed at a ureteral lesion, such as endoscopic fulguration, rather than diagnostic inspection or biopsy alone.
A urologist uses a ureteroscope to treat a lesion within the ureter, with the therapeutic work performed endoscopically rather than through an open incision. Fulguration is a typical example of treatment directed at a ureteral lesion. The procedure is generally performed in an operating-room or other procedural facility; the record should identify the lesion and describe the treatment actually carried out.
Select this code when the operative report supports endoscopic treatment, not merely inspection or tissue sampling. Document the treated site, findings, and technique. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies rather than pricing each as an unrelated procedure. For bilateral reporting, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 50957
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.61 · 49%
- Practice expense (office) RVU5.96 · 44%
- Malpractice RVU0.85 · 6%
13
Medicare services in 2024 · #6130 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.
50957 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
50970 is for diagnostic ureteroscopy. When the same session proceeds to lesion treatment, report the therapeutic service rather than treating diagnostic inspection as a separate procedure.
$411.34–$451.89
Both codes are in the ureteroscopic treatment family. Compare the operative details with each code’s full descriptor and report the code that matches the intervention performed.
No office rate
50976 is another ureteroscopic treatment code. The operative report’s specific treatment and the full code descriptor determine which code fits.
Compare 50957 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
$454.88
Facility
$310.67
Seattle (King Cnty) →
Office / nonfacility
$499.27
Facility
$331.24
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50957 billing questions
When is 50957 preferable to the biopsy code 50955?
Use 50957 when the documented work treats a ureteral lesion endoscopically. Use 50955 when the service is ureteroscopic biopsy rather than lesion treatment.
Can diagnostic ureteroscopy be reported separately with 50957?
The diagnostic inspection that leads to treatment during the same operative session is part of the therapeutic endoscopy. Related endoscopies performed together are subject to CMS endoscopy-family pricing.
How should bilateral treatment be reported?
Report modifier 50 when the procedure is performed bilaterally; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
What documentation supports 50957?
The operative report should identify the ureteral lesion and describe the endoscopic treatment performed, such as fulguration. A report describing inspection or biopsy alone does not support this treatment 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.
6,00550951,,Endoscopy of ureter,A,,5.68,5.37,,1.66,,0.72,11.77,8.06,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,00650953,,Endoscopy of ureter,A,,6.07,5.63,,1.75,,0.79,12.49,8.61,0,000,0.00,0.00,0.00,3,1,0,0,0,9,50951,33.4009,09,0,99,0.00,0.00,0.00
6,00750955,,Ureter endoscopy & biopsy,A,,6.57,5.88,,1.85,,0.85,13.30,9.27,0,000,0.00,0.00,0.00,3,1,0,0,0,9,50951,33.4009,09,0,99,0.00,0.00,0.00
6,00850957,,Ureter endoscopy & treatment,A,,6.61,5.96,,1.86,,0.85,13.42,9.32,0,000,0.00,0.00,0.00,3,1,0,0,0,9,50951,33.4009,09,0,99,0.00,0.00,0.00
6,00950961,,Ureter endoscopy & treatment,A,,5.89,5.48,,1.71,,0.76,12.13,8.36,0,000,0.00,0.00,0.00,3,1,0,0,0,9,50951,33.4009,09,0,99,0.00,0.00,0.00
6,01050970,,Ureter endoscopy,A,,6.95,1.88,NA,1.88,,0.90,9.73,9.73,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,01150972,,Ureter endoscopy & catheter,A,,6.71,1.83,NA,1.83,,0.87,9.41,9.41,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00