He was promised four and a half lakh rupees by a middleman who said he would organise both the paperwork and a hospital at which the kidney would be removed. He delivered on that part of the deal - the paperwork appears chillingly legitimate with signatures of doctors and government officials, that attest that the transaction was legal, and that Mr Rao donated his kidney voluntarily out of "love and affection for the recipient."
But Mr Rao was paid only a third of the agreed-upon amount.
He says his desperation peaked in 2009, when his crop of chilies was destroyed by erratic rains. He then borrowed heavily from a money-lender to set up a small business which failed. The monthly payments were unaffordable. The offer for his kidney was tough to refuse.
"My mother and wife refused to give their consent. They were totally against it. I threatened that I would otherwise have to simply commit suicide,'' he says. "The middleman cheated me of more than two lakh rupees. But I could complain to no one. Now I am in poor health. Unable to work. My loans remain and I had to flee from my village and live anonymously.''
Guntur in Andhra Pradesh, a largely agricultural belt where farmers grow mainly chillies and cotton, has been battered by drought, cyclones and unseasonal rain. If in one year, chillies and cotton drew good prices, farmers planted more of them. And then prices crashed.
Mr Rao's story does not shock locals. Other farmers from the backward Palanadu region, burdened by debt, have sold their kidneys, only to receive a fraction of the agreed-upon payment. Some turned into middlemen themselves, soliciting business among poor farmers they knew well.
Documents show the surgeries were done in top corporate hospitals in Hyderabad, after the mandatory authorisation by a committee to meet the legal requirements of the Human Organs Transplant Act.
Most donors choose to stay anonymous, worried about legal consequences. "Many of them are conscious that they voluntarily took a decision to give their kidney and get some financial help. The paperwork is such that it may not stand scrutiny in a court of law," says senior police officer J Satyanarayana. No police case has been filed so far.
The State Human Rights Commission has now asked the government to submit a report on the ground situation and on what the authorities are doing to address this illegal racket in sale of organs. The report is to be given by the end of April.