CPT 50520
Global 090 ActiveClose kidney-skin fistula
CPT 50520 Billing & Documentation Guide
CPT code 50520 (Close kidney-skin fistula) is classified under Surgery (Urinary/Reproductive) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 18.41, a non-facility practice expense RVU of 9.47, and a malpractice RVU of 4.91, a total non-facility RVU of 32.79 and facility RVU of 32.79. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1097.96, though rates vary from $968.44 to $1358.94 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 50520, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 50520 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 50520 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 50520
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 18.41 | 18.41 |
| Practice Expense RVU | 9.47 | 9.47 |
| Malpractice RVU | 4.91 | 4.91 |
| Total RVU | 32.79 | 32.79 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 50520
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $1100.16 | $1100.16 | $1059.94 - $1226.57 | 29 |
| Florida | $1251.52 | $1251.52 | $1163.79 - $1358.94 | 3 |
| Georgia | $1113.81 | $1113.81 | $1092.54 - $1135.08 | 2 |
| Illinois | $1236.1 | $1236.1 | $1160.03 - $1313.48 | 4 |
| Michigan | $1142.75 | $1142.75 | $1088.85 - $1196.65 | 2 |
| North Carolina | $1014.82 | $1014.82 | $1014.82 - $1014.82 | 1 |
| New York | $1219.9 | $1219.9 | $1030.69 - $1334.9 | 5 |
| Ohio | $1069.01 | $1069.01 | $1069.01 - $1069.01 | 1 |
| Pennsylvania | $1105.58 | $1105.58 | $1060.26 - $1150.9 | 2 |
| Texas | $1082.03 | $1082.03 | $1055.1 - $1159.58 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 50520
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 50520 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 50520
What does CPT code 50520 mean? +
CPT code 50520 represents: Close kidney-skin fistula. It's in the Surgery (Urinary/Reproductive) category with a global period of 090.
What is the Medicare reimbursement for CPT 50520? +
The 2026 Medicare national average non-facility payment for CPT 50520 is $1097.96. Rates range from $968.44 to $1358.94 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 50520? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 50520? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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