CPT 50540
Global 090 ActiveRevision of horseshoe kidney
CPT 50540 Billing & Documentation Guide
CPT code 50540 (Revision of horseshoe kidney) is classified under Surgery (Urinary/Reproductive) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 20.57, a non-facility practice expense RVU of 7.49, and a malpractice RVU of 2.64, a total non-facility RVU of 30.7 and facility RVU of 30.7. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1037.67, though rates vary from $947.37 to $1345.61 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 50540, 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 50540 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 50540 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 50540
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 20.57 | 20.57 |
| Practice Expense RVU | 7.49 | 7.49 |
| Malpractice RVU | 2.64 | 2.64 |
| Total RVU | 30.7 | 30.7 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 50540
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 | $1055.52 | $1055.52 | $1020.19 - $1170.65 | 29 |
| Florida | $1109.72 | $1109.72 | $1058.75 - $1170.49 | 3 |
| Georgia | $1032.26 | $1032.26 | $1015.32 - $1049.2 | 2 |
| Illinois | $1099.7 | $1099.7 | $1053.29 - $1145.66 | 4 |
| Michigan | $1046.08 | $1046.08 | $1015.02 - $1077.14 | 2 |
| North Carolina | $976.81 | $976.81 | $976.81 - $976.81 | 1 |
| New York | $1118.6 | $1118.6 | $986.71 - $1192.23 | 5 |
| Ohio | $1004.35 | $1004.35 | $1004.35 - $1004.35 | 1 |
| Pennsylvania | $1032.55 | $1032.55 | $1000.04 - $1065.05 | 2 |
| Texas | $1019.04 | $1019.04 | $996.63 - $1062.31 | 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 50540
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 50540 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 50540
What does CPT code 50540 mean? +
CPT code 50540 represents: Revision of horseshoe kidney. It's in the Surgery (Urinary/Reproductive) category with a global period of 090.
What is the Medicare reimbursement for CPT 50540? +
The 2026 Medicare national average non-facility payment for CPT 50540 is $1037.67. Rates range from $947.37 to $1345.61 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 50540? +
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 50540? +
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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