# CPT 50590: Lithotripsy, extracorporeal shock wave

Medicare CPT 50590 pays $760.20 in a non-facility setting and $521.05 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $683.76 in Arkansas to $926.97 in Alaska, a 36% spread.

Web page: https://www.med-reveal.com/rates/50590-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Urology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $760.20 |
| National facility | $521.05 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $926.97 | $672.27 |
| District of Columbia | $853.38 | $571.66 |
| New York | $836.40 | $569.60 |
| New Jersey | $830.49 | $561.20 |
| California | $826.27 | $543.28 |
| Washington | $817.68 | $545.05 |
| Massachusetts | $812.35 | $543.67 |
| Connecticut | $806.06 | $548.50 |
| Florida | $800.43 | $560.49 |
| Hawaii | $797.82 | $525.91 |
| Illinois | $785.22 | $554.14 |
| Maryland | $784.56 | $535.24 |
| Colorado | $780.68 | $526.22 |
| Rhode Island | $775.04 | $528.00 |
| Oregon | $772.84 | $520.89 |
| New Hampshire | $771.50 | $522.55 |
| Puerto Rico | $764.00 | $522.22 |
| Virgin Islands | $764.00 | $522.22 |
| Montana | $760.12 | $520.97 |
| Pennsylvania | $757.69 | $523.44 |
| Nevada | $753.74 | $514.35 |
| Delaware | $752.84 | $516.56 |
| Texas | $752.82 | $517.38 |
| Michigan | $752.50 | $527.93 |
| Georgia | $750.32 | $522.17 |
| Wyoming | $749.52 | $510.37 |
| Minnesota | $742.91 | $496.82 |
| Arizona | $741.86 | $510.13 |
| Virginia | $741.31 | $506.23 |
| Vermont | $735.90 | $499.14 |
| North Dakota | $735.80 | $496.65 |
| New Mexico | $735.19 | $515.89 |
| South Dakota | $732.93 | $493.77 |
| Utah | $731.97 | $507.16 |
| Louisiana | $727.27 | $508.92 |
| Maine | $727.03 | $498.52 |
| Missouri | $726.56 | $507.10 |
| Ohio | $725.66 | $507.32 |
| West Virginia | $725.41 | $517.58 |
| South Carolina | $723.58 | $502.61 |
| North Carolina | $718.52 | $495.39 |
| Wisconsin | $714.94 | $485.83 |
| Kentucky | $712.22 | $499.62 |
| Indiana | $709.83 | $488.14 |
| Oklahoma | $708.16 | $494.59 |
| Idaho | $706.49 | $486.47 |
| Tennessee | $704.71 | $487.32 |
| Nebraska | $703.79 | $483.05 |
| Iowa | $701.36 | $482.54 |
| Kansas | $701.35 | $485.16 |
| Mississippi | $693.77 | $487.86 |
| Alabama | $692.27 | $483.02 |
| Arkansas | $683.76 | $478.33 |

## Related codes

- 50010: Renal exploration, not necessitating other specific procedures — https://www.med-reveal.com/rates/50010-cpt-fee-schedule
- 50060: Nephrolithotomy, removal of calculus — https://www.med-reveal.com/rates/50060-cpt-fee-schedule
- 50120: Pyelotomy, with exploration — https://www.med-reveal.com/rates/50120-cpt-fee-schedule
- 50200: Renal biopsy, percutaneous, needle — https://www.med-reveal.com/rates/50200-cpt-fee-schedule
- 50230: Nephrectomy, radical, transperitoneal or retroperitoneal — https://www.med-reveal.com/rates/50230-cpt-fee-schedule
- 50240: Nephrectomy, partial — https://www.med-reveal.com/rates/50240-cpt-fee-schedule
- 50250: Cryosurgical ablation of renal mass, percutaneous — https://www.med-reveal.com/rates/50250-cpt-fee-schedule
- 50320: Donor nephrectomy, open, from living donor — https://www.med-reveal.com/rates/50320-cpt-fee-schedule

Commercial negotiated rates for 50590 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules