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CPT code 51590: Bladder removal, cutaneous urinary diversion2026 Medicare rate & RVUs

Reports complete bladder removal with urinary drainage redirected to the skin through a ureterostomy or an ileal conduit, commonly during bladder cancer surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities609 Medicare services in 2024

Medicare pays $1,711.80 for 51590 nationally in a facility.

Medicare rate · 51590

Bladder removal, cutaneous urinary diversion

Office or facility?

Work RVUs
35.42
Total RVUs
51.25
Global days
090

National rate · 2026

$1,711.80

Facility setting, before claim adjustments.

See every locality for 51590 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 51590 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 51590 covers

A urologist removes the entire bladder and creates a route for urine to reach a stoma on the abdominal skin. The diversion may bring the ureters directly to the skin or connect them to a segment of ileum that functions as a conduit. This operation is commonly performed in a hospital for bladder cancer requiring cystectomy; the patient collects urine in an external ostomy appliance.

Select this code when the operative service includes complete cystectomy and one of these cutaneous diversions, without the bilateral pelvic lymphadenectomy represented by a related code. The operative report should establish the extent of bladder removal, the diversion method, and whether bilateral pelvic nodes were removed. The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery 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 51590 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

51590 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,597.09
AlaskaUnavailable$2,256.83
ArizonaUnavailable$1,677.63
ArkansasUnavailable$1,583.13
Atlanta, GAUnavailable$1,752.91
Austin, TXUnavailable$1,717.77
Bakersfield, CAUnavailable$1,708.42
Baltimore area, MDUnavailable$1,795.12
Beaumont, TXUnavailable$1,667.20
Brazoria, TXUnavailable$1,683.31

51590 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
51590 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 51590 rate is calculated

Each of 51590’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 · 51590

RVUs × geographic indexes × conversion factor

Office or facility?

Work35.42

35.42 RVUs× 1.000 GPCI

Practice expense11.12

11.12 RVUs× 1.000 GPCI

Malpractice4.71

4.71 RVUs× 1.000 GPCI

Adjusted RVUs

51.2500

Conversion factor

$33.4009

Medicare rate

$1,711.80

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 51590

51590 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 51590

Bladder removal, cutaneous urinary diversion

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.08/0.83/0.09Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 51590

Bladder removal, cutaneous urinary 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

51590 without 51 · national facility

$1,711.80

Bladder removal, cutaneous urinary diversion

51590-51 · Second procedure: 50%

$855.90

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%).

When to use modifier 51

51590 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 51590

    Bladder removal, cutaneous urinary diversion35.42 wRVU

    Not priced

  • 51595

    Bladder removal, continent intestinal reservoir40.29 wRVU

    Not priced

  • 51580

    Complete cystectomy, ureterostomy or ureterosigmoidostomy34.49 wRVU

    Not priced

  • 51596

    Bladder removal, continent urinary diversion43.15 wRVU

    Not priced

  • 51570

    Cystectomy, complete excision, separate procedure26.77 wRVU

    Not priced

How to choose

51595Bladder removalContinent intestinal reservoir
Choose 51595 when bilateral pelvic lymphadenectomy accompanies complete cystectomy and cutaneous urinary diversion; 51590 describes the diversion operation without that node dissection.
51580Complete cystectomyUreterostomy or ureterosigmoidostomy
51580 uses a sigmoid-based urinary diversion. This code describes a cutaneous ureterostomy or ureteroileostomy.
51596Bladder removalContinent urinary diversion
51596 is for a continent urinary diversion. Choose 51590 for a cutaneous diversion that drains to an external ostomy appliance.
51570CystectomyComplete excision, separate procedure
51570 reports complete cystectomy without the cutaneous urinary diversion included in 51590.

Codes related to 51590

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 51590
CodeHow it relatesNational office range
Same family
51595Bladder removal, continent intestinal reservoirAdds bilateral pelvic lymphadenectomy to complete cystectomy with cutaneous urinary diversion.No office rate
51585Cystectomy, nodes and ureteral diversionPairs a sigmoid urinary diversion with bilateral pelvic lymphadenectomy.No office rate
51570Cystectomy, complete excision, separate procedureComplete cystectomy without the cutaneous diversion specified by 51590.No office rate
Used instead
51580Complete cystectomy, ureterostomy or ureterosigmoidostomyComplete cystectomy with urinary diversion to the sigmoid rather than a cutaneous diversion.No office rate
51596Bladder removal, continent urinary diversionComplete cystectomy with a continent urinary diversion instead of an external cutaneous conduit.No office rate

51590 billing questions

How does this code differ from 51595?

51590 describes complete cystectomy with a cutaneous ureterostomy or ureteroileostomy. Use 51595 when the operation also includes bilateral pelvic lymphadenectomy.

Is creation of the urinary diversion included?

Yes. The code represents the cystectomy with the specified cutaneous diversion, whether the ureters reach the skin directly or through an ileal conduit.

Can modifier 50 be appended?

No. CMS identifies bilateral adjustment as inappropriate for this code; the operative anatomy and service are not reported with modifier 50.

What supports reporting 51590 rather than another cystectomy code?

The operative report should document complete bladder removal and whether urine was diverted by cutaneous ureterostomy or ureteroileostomy. It should also clarify whether bilateral pelvic lymphadenectomy was performed.

How are assistant and co-surgeon services handled?

An assistant at surgery may be paid. Co-surgeon payment requires 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

Show the CMS file lines behind this rate
RVUs for 51590PPRRVU2026_Oct_nonQPP.csv, line 6,038 (RVU26D)

Open CMS sourceHow we calculate rates

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