No office rate
50060 describes routine open renal calculus removal. Report 50065 when the documented operative circumstances support a secondary operation.
On this page
CMS RVU26D · Effective 2026-10-01
50065 Kidney stone surgery Medicare reimbursement rates in Wyoming
Reports a secondary open operation to remove a kidney stone when the documented surgical circumstances distinguish it from routine initial stone removal. Compare 50065 office and facility rates across CMS payment localities in Wyoming.
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 50065 in Wyoming?
Wyoming has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1053.95
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
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.
Urologic surgery
About 50065: Secondary open renal stone operation
Reports a secondary open operation to remove a kidney stone when the documented surgical circumstances distinguish it from routine initial stone removal.
A urologist uses this code for a secondary open operation to remove a calculus from the kidney. The procedure involves surgically reaching the kidney and treating the stone through an open approach, typically in a hospital operating room. The code distinguishes this service from routine open stone removal and from percutaneous procedures that reach the kidney through a small access tract.
Choose the code based on the operative circumstances, not stone size alone; the record should describe the calculus, the open approach, and why the operation is secondary. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. For bilateral surgery reported with modifier 50, payment is at 150%. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
CMS billing rules for 50065
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU21.76 · 67%
- Practice expense (office) RVU7.73 · 24%
- Malpractice RVU2.79 · 9%
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.
50065 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
50075 identifies open removal of a large staghorn calculus. Do not select 50065 based on stone size when the large-staghorn service applies.
No office rate
50080 is a percutaneous stone-treatment service for stones up to 2 cm; 50065 describes a secondary open operation.
No office rate
50081 is the percutaneous code for larger or more complex stone treatment. The operative approach distinguishes it from 50065.
Compare 50065 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.
1 of 1 payment localities
Wyoming** →
Office / nonfacility
Unavailable
Facility
$1053.95
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 50065 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,871
- Code
- 50065
- Physician work
- 21.76
- Practice expense
- 7.73
- Malpractice
- 2.79
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.76 | × 1.000 | 21.7600 |
| Practice expense | 7.73 | × 1.000 | 7.7300 |
| Malpractice | 2.79 | × 0.740 | 2.0646 |
| Total RVUs | 31.5546 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1053.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.76 | 1 |
| Practice expense | 7.73 | 1 |
| Malpractice | 2.79 | 0.74 |
(21.76 × 1 + 7.73 × 1 + 2.79 × 0.74) × $33.4009 = $1053.95
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
50065 billing questions
How does this differ from 50060?
50065 is for a secondary open operation for a renal calculus. Use 50060 for routine open removal when the circumstances do not support reporting a secondary operation.
Does stone size determine whether to report 50065?
No. The selection turns on the secondary-operation circumstances, not stone size alone. A large staghorn calculus has a distinct open procedure code, 50075.
Can the kidney incision and stone extraction be billed separately?
The access to the kidney and treatment of the calculus are part of the open stone operation; do not separately report those operative steps as distinct services.
How is bilateral surgery paid?
When the procedure is performed bilaterally and reported with modifier 50, CMS pays at 150%.
What documentation supports reporting 50065?
Document the kidney and calculus treated, the open approach, and the operative circumstances supporting classification as a secondary operation. The operative report should make the distinction from routine stone removal clear.
Can an assistant surgeon be reported?
Assistant-at-surgery payment may be made for this code. Co-surgeons and team surgery are not permitted under the CMS rules provided.
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.
5,86850045,,Nephrotomy w/exploration,A,,16.40,6.62,NA,6.62,,2.11,25.13,25.13,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,8695005F,,Pt counsld on exam for moles,I,,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
5,87050060,,Nl removal calculus,A,,20.43,7.46,NA,7.46,,2.62,30.51,30.51,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,87150065,,Nl sec surg operj calculus,A,,21.76,7.73,NA,7.73,,2.79,32.28,32.28,0,090,0.08,0.83,0.09,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,