No office rate
Use 50525 for a connection from the kidney to an internal organ; 50520 describes a connection from the kidney to the skin.
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CMS RVU26D · Effective 2026-10-01
50525 Fistula closure Medicare reimbursement rates in Wyoming
Reports surgical closure of an abnormal connection between a kidney and an internal organ, such as bowel, when the fistula is repaired. Compare 50525 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 50525 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
$1323.56
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 50525: Nephrovisceral fistula closure
Reports surgical closure of an abnormal connection between a kidney and an internal organ, such as bowel, when the fistula is repaired.
This operation closes an abnormal tract connecting the kidney to an internal organ, such as the colon. A urologist typically performs the renal portion of the repair; another surgeon may participate when the connected organ also requires operative management. The operative report should identify the kidney, the connected viscus, and the repair performed. This code distinguishes a kidney-to-viscus fistula from a tract that drains to the skin.
Report the service when the surgeon repairs the nephrovisceral connection. If the closure is performed with partial nephrectomy, compare the operative work with 50526. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 50525
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU23.78 · 58%
- Practice expense (office) RVU11.14 · 27%
- Malpractice RVU6.36 · 15%
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.
50525 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
50526 is the related code when fistula closure is performed with partial nephrectomy; use 50525 when that additional renal resection is not performed.
No office rate
50500 addresses repair of a kidney wound. It is not the fistula-closure code for an abnormal connection between the kidney and an internal organ.
Compare 50525 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
$1323.56
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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 50525 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,928
- Code
- 50525
- Physician work
- 23.78
- Practice expense
- 11.14
- Malpractice
- 6.36
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 23.78 | × 1.000 | 23.7800 |
| Practice expense | 11.14 | × 1.000 | 11.1400 |
| Malpractice | 6.36 | × 0.740 | 4.7064 |
| Total RVUs | 39.6264 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1323.56
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 23.78 | 1 |
| Practice expense | 11.14 | 1 |
| Malpractice | 6.36 | 0.74 |
(23.78 × 1 + 11.14 × 1 + 6.36 × 0.74) × $33.4009 = $1323.56
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.
50525 billing questions
How is this different from 50520?
50525 is for a fistula connecting the kidney to an internal organ. 50520 is for a kidney-to-skin fistula.
When should 50526 be considered instead?
Consider 50526 when the nephrovisceral fistula closure is performed with partial nephrectomy. The operative report should support the additional renal resection.
Can modifier 50 be reported for a bilateral repair?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the multiple-procedure reduction affect payment?
For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What postoperative care is included in the global period?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
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.
5,92550500,,Repair of kidney wound,A,,20.69,10.02,NA,10.02,,5.53,36.24,36.24,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,9265050F,,Plan 2 main dr by 1 month,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
5,92750520,,Close kidney-skin fistula,A,,18.41,9.47,NA,9.47,,4.91,32.79,32.79,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92850525,,Close nephrovisceral fistula,A,,23.78,11.14,NA,11.14,,6.36,41.28,41.28,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,92950526,,Close nephrovisceral fistula,A,,25.65,11.60,NA,11.60,,6.85,44.10,44.10,0,090,0.08,0.83,0.09,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,93050540,,Revision of horseshoe kidney,A,,20.57,7.49,NA,7.49,,2.64,30.70,30.70,0,090,0.08,0.83,0.09,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,93150541,,Laparo ablate renal cyst,A,,16.44,5.99,NA,5.99,,2.15,24.58,24.58,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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.,,,,,,