No office rate
Use 50845 for the appendix-based channel from bladder to abdominal wall. Code 50825 describes a bowel-based continent urinary diversion, not that channel.
On this page
CMS RVU26D · Effective 2026-10-01
50845 Bladder channel Medicare reimbursement rates in Wyoming
Creation of an appendix-based channel from the bladder to the abdominal wall, typically allowing a patient with difficult urethral access to catheterize and empty the bladder. Compare 50845 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 50845 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
$1104.13
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 50845: Appendix-based catheterizable bladder channel
Creation of an appendix-based channel from the bladder to the abdominal wall, typically allowing a patient with difficult urethral access to catheterize and empty the bladder.
The surgeon uses the appendix to form a channel between the bladder and an abdominal opening that can be catheterized to drain urine. Urologists, including pediatric urologists, commonly perform this reconstruction for patients with neurogenic bladder or congenital urinary tract conditions who need a reliable catheterization route but cannot readily catheterize through the urethra. The procedure is performed in an operating room and may be part of a broader urinary reconstruction.
Report 50845 when the operative work creates this appendiceal channel; document the channel’s construction and its connection to the bladder and abdominal wall. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. If another separately reportable procedure is performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 50845
- 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 RVU21.90 · 65%
- Practice expense (office) RVU9.07 · 27%
- Malpractice RVU2.82 · 8%
31
Medicare services in 2024 · #5650 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.
50845 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Code 50820 describes an ileal conduit for urinary drainage. Code 50845 creates a catheterizable route that connects the bladder to an abdominal opening.
No office rate
Code 50860 routes a ureter to the skin. Code 50845 uses the appendix to create access for catheterizing and emptying the bladder.
Compare 50845 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
$1104.13
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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 50845 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,995
- Code
- 50845
- Physician work
- 21.90
- Practice expense
- 9.07
- Malpractice
- 2.82
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 21.90 | × 1.000 | 21.9000 |
| Practice expense | 9.07 | × 1.000 | 9.0700 |
| Malpractice | 2.82 | × 0.740 | 2.0868 |
| Total RVUs | 33.0568 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1104.13
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 21.9 | 1 |
| Practice expense | 9.07 | 1 |
| Malpractice | 2.82 | 0.74 |
(21.9 × 1 + 9.07 × 1 + 2.82 × 0.74) × $33.4009 = $1104.13
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.
50845 billing questions
How is 50845 different from a continent urinary diversion?
50845 describes a catheterizable channel made using the appendix to connect the bladder with an abdominal opening. A bowel-based continent diversion involves a different reconstruction and should be selected according to the anatomy and work documented.
Is bladder augmentation included in 50845?
The code describes creation of the appendiceal catheterization channel, not bladder enlargement. If augmentation is also performed, document that distinct work and determine separate reporting under the applicable coding edits.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
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 services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.
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.
5,99250825,,Construct bowel bladder,A,,29.91,10.08,NA,10.08,,3.85,43.84,43.84,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99350830,,Revise urine flow,A,,32.93,10.70,NA,10.70,,4.23,47.86,47.86,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99450840,,Replace ureter by bowel,A,,21.83,8.40,NA,8.40,,2.81,33.04,33.04,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99550845,,Appendico-vesicostomy,A,,21.90,9.07,NA,9.07,,2.82,33.79,33.79,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99650860,,Transplant ureter to skin,A,,16.65,6.67,NA,6.67,,2.14,25.46,25.46,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99750900,,Repair of ureter,A,,14.66,6.25,NA,6.25,,1.88,22.79,22.79,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,99850920,,Closure ureter/skin fistula,A,,15.41,6.41,NA,6.41,,1.98,23.80,23.80,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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.,,,,,,