CPT 50590
Global 090 ActiveFragmenting of kidney stone
CPT 50590 Billing & Documentation Guide
CPT code 50590 (Fragmenting of kidney stone) is classified under Surgery (Urinary/Reproductive) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 9.53, a non-facility practice expense RVU of 12, and a malpractice RVU of 1.23, a total non-facility RVU of 22.76 and facility RVU of 15.6. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $778.28, though rates vary from $683.76 to $953.31 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 50590, 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 50590 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 50590 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 50590
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 9.53 | 9.53 |
| Practice Expense RVU | 12 | 4.84 |
| Malpractice RVU | 1.23 | 1.23 |
| Total RVU | 22.76 | 15.6 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 50590
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 | $826.27 | $543.28 | $785.03 - $953.31 | 29 |
| Florida | $800.43 | $560.49 | $763.23 - $839.45 | 3 |
| Georgia | $750.32 | $522.17 | $724.8 - $775.83 | 2 |
| Illinois | $785.22 | $554.14 | $748.46 - $817.64 | 4 |
| Michigan | $752.5 | $527.94 | $730.63 - $774.36 | 2 |
| North Carolina | $718.52 | $495.39 | $718.52 - $718.52 | 1 |
| New York | $836.4 | $569.6 | $727.96 - $891.54 | 5 |
| Ohio | $725.66 | $507.32 | $725.66 - $725.66 | 1 |
| Pennsylvania | $757.69 | $523.44 | $725.08 - $790.3 | 2 |
| Texas | $752.82 | $517.38 | $721.21 - $779.4 | 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 50590
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 50590 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 50590
What does CPT code 50590 mean? +
CPT code 50590 represents: Fragmenting of kidney stone. It's in the Surgery (Urinary/Reproductive) category with a global period of 090.
What is the Medicare reimbursement for CPT 50590? +
The 2026 Medicare national average non-facility payment for CPT 50590 is $778.28. Rates range from $683.76 to $953.31 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 50590? +
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 50590? +
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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