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50431 Njx px nfrosgrm &/urtrgrm

What 50431 is

CMS fee schedule short descriptor: Njx px nfrosgrm &/urtrgrm.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 50431 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)1.078.030.129.22$307.96
Facility (hospital, ASC)1.070.580.121.77$59.12

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply (endoscopic or minor procedure: global period is the day of the procedure).

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Medically Unlikely Edit (MUE)

Medicare caps 50431 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 50431? These codes are bundled into it

50431 is a Column 1 code in 226 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0709TId ca immntx each addl njx1 - modifier may bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair
12011Rpr f/e/e/n/l/m 2.5 cm/<1 - modifier may bypassCheck pair
12013Rpr f/e/e/n/l/m 2.6-5.0 cm1 - modifier may bypassCheck pair
12014Rpr f/e/e/n/l/m 5.1-7.5 cm1 - modifier may bypassCheck pair
12015Rpr f/e/e/n/l/m 7.6-12.5 cm1 - modifier may bypassCheck pair
12016Rpr fe/e/en/l/m 12.6-20.0 cm1 - modifier may bypassCheck pair
12017Rpr fe/e/en/l/m 20.1-30.0 cm1 - modifier may bypassCheck pair
12018Rpr f/e/e/n/l/m >30.0 cm1 - modifier may bypassCheck pair
12020Tx supfc wnd dehsn smpl clsr1 - modifier may bypassCheck pair
12021Tx supfc wnd dehsn w/packing1 - modifier may bypassCheck pair
12031Intmd rpr s/a/t/ext 2.5 cm/<1 - modifier may bypassCheck pair
12032Intmd rpr s/a/t/ext 2.6-7.51 - modifier may bypassCheck pair
12034Intmd rpr s/tr/ext 7.6-12.51 - modifier may bypassCheck pair
12035Intmd rpr s/a/t/ext 12.6-201 - modifier may bypassCheck pair
12036Intmd rpr s/a/t/ext 20.1-301 - modifier may bypassCheck pair
12037Intmd rpr s/tr/ext >30.0 cm1 - modifier may bypassCheck pair

Showing 30 of 226 column 2 codes. Use the pair checker for any specific combination.

50431 is bundled into these codes

50431 appears as a Column 2 code in 27 active edits. Reported with one of these Column 1 codes on the same date of service, 50431 is the code that denies.

Column 1 codeShort descriptionModifier indicator
50080Perq nl/pl lithotrp smpl<2cm1Check pair
50081Perq nl/pl lithotrp cplx>2cm1Check pair
50382Change ureter stent percut1Check pair
50384Remove ureter stent percut1Check pair
50387Change nephroureteral cath1Check pair
50389Remove renal tube w/fluoro1Check pair
50430Njx px nfrosgrm &/urtrgrm1Check pair
50432Plmt nephrostomy catheter1Check pair
50433Plmt nephroureteral catheter1Check pair
50434Convert nephrostomy catheter1Check pair
50435Exchange nephrostomy cath1Check pair
50436Dilat xst trc ndurlgc px1Check pair
50437Dilat xst trc new access rcs1Check pair
50551Kidney endoscopy1Check pair
50555Kidney endoscopy & biopsy1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.