CPT code 51585: Cystectomy, nodes and ureteral diversion2026 Medicare rate & RVUs in Illinois
Reports complete bladder removal with bilateral pelvic lymph node dissection and urinary diversion by ureterosigmoidostomy or ureterostomy.
CMS doesn’t publish an office rate for 51585 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 51585 covers
51585 covers complete surgical removal of the bladder, bilateral pelvic lymph node dissection, and urinary diversion by connecting the ureters to the sigmoid colon or creating a ureterostomy. Urologists typically perform this major operation in a hospital operating room, often for bladder cancer requiring definitive surgery. The selected diversion must match the operative report; this code does not describe an ileal conduit or continent pouch.
Report the code when the surgeon performs all three elements. Documentation should identify complete bladder removal, bilateral pelvic lymphadenectomy, and the diversion method. The diversion work is included in the code. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. The code is priced as bilateral, so modifier 50 does not increase payment. Assistant-at-surgery services may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 51585 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $2,094.08 |
| East St. Louis, IL | Unavailable | $2,003.49 |
| Rest of Illinois | Unavailable | $1,925.89 |
| Suburban Chicago, IL | Unavailable | $2,016.50 |
How the 51585 rate is calculated
Each of 51585’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 51585
RVUs × geographic indexes × conversion factor
Work38.65
38.65 RVUs× 1.000 GPCI
Practice expense12.33
12.33 RVUs× 1.000 GPCI
Malpractice4.96
4.96 RVUs× 1.000 GPCI
Adjusted RVUs
55.9400
Conversion factor
$33.4009
Medicare rate
$1,868.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 51585
51585 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 51585
Cystectomy, nodes and ureteral diversion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 51585
Cystectomy, nodes and ureteral diversion
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
51585 without 51 · national facility
$1,868.45
Cystectomy, nodes and ureteral diversion
51585-51 · Second procedure: 50%
$934.23
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
51585 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 51575Bladder removalWith bilateral node dissection
- Use 51575 when complete bladder removal and bilateral pelvic lymphadenectomy are performed without the ureterosigmoidostomy or ureterostomy included in 51585.
- 51580Complete cystectomyUreterostomy or ureterosigmoidostomy
- 51580 includes ureterosigmoidostomy or ureterostomy with complete bladder removal but does not include bilateral pelvic lymphadenectomy.
- 51590Bladder removalCutaneous urinary diversion
- 51590 describes an ileal conduit or sigmoid bladder diversion. 51585 instead includes ureterosigmoidostomy or ureterostomy and bilateral pelvic lymphadenectomy.
51585 billing questions
How does 51585 differ from 51575?
Both include complete bladder removal and bilateral pelvic lymphadenectomy. 51585 also includes urinary diversion by ureterosigmoidostomy or ureterostomy.
Can the diversion be reported separately?
The ureterosigmoidostomy or ureterostomy is part of 51585. The code includes that diversion work.
Should modifier 50 be appended for the bilateral node dissection?
The code is already priced as bilateral, and modifier 50 does not increase payment.
What documentation supports reporting 51585?
The operative report should establish complete bladder removal, bilateral pelvic lymphadenectomy, and whether the ureters were diverted to the sigmoid colon or through a ureterostomy.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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