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CPT code 51865: Bladder wound repair, complicated repair2026 Medicare rate & RVUs

Report complicated surgical closure of a bladder wound, such as a bladder injury requiring more involved repair than a simple wound closure.

CMS RVU26DEffective Oct 1, 2026109 payment localities584 Medicare services in 2024

Medicare pays $809.97 for 51865 nationally in a facility.

Medicare rate · 51865

Bladder wound repair, complicated repair

Office or facility?

Work RVUs
15.41
Total RVUs
24.25
Global days
090

National rate · 2026

$809.97

Facility setting, before claim adjustments.

See every locality for 51865 →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 51865 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 51865 covers

This service covers surgical repair of a complicated bladder wound, including a bladder laceration or an injury encountered during another operation. A urologist or other surgeon typically performs the repair in an operating room, often during surgery for abdominal or pelvic trauma or a procedure that has injured the bladder. The operative record should identify the wound and explain the work that makes the repair complicated.

Choose this code when the documented repair is complicated rather than a simple bladder-wound closure; the operative approach or setting alone does not establish that distinction. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this bladder repair. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery billing 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 51865 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

51865 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$750.25
AlaskaUnavailable$1,048.58
ArizonaUnavailable$792.48
ArkansasUnavailable$742.95
Atlanta, GAUnavailable$829.90
Austin, TXUnavailable$815.43
Bakersfield, CAUnavailable$812.15
Baltimore area, MDUnavailable$851.87
Beaumont, TXUnavailable$784.80
Brazoria, TXUnavailable$795.86

51865 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
51865 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 51865 rate is calculated

Each of 51865’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 · 51865

RVUs × geographic indexes × conversion factor

Office or facility?

Work15.41

15.41 RVUs× 1.000 GPCI

Practice expense6.63

6.63 RVUs× 1.000 GPCI

Malpractice2.21

2.21 RVUs× 1.000 GPCI

Adjusted RVUs

24.2500

Conversion factor

$33.4009

Medicare rate

$809.97

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

Payment rules and modifiers for 51865

51865 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 51865

Bladder wound repair, complicated repair

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 · 51865

Bladder wound repair, complicated repair

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

51865 without 51 · national facility

$809.97

Bladder wound repair, complicated repair

51865-51 · Second procedure: 50%

$404.99

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

51865 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 51865

    Bladder wound repair, complicated repair15.41 wRVU

    Not priced

  • 51860

    Bladder repair, simple wound suture12.29 wRVU

    Not priced

  • 51880

    Cystostomy closure, existing urinary opening7.67 wRVU

    Not priced

  • 51800

    Bladder outlet reconstruction, bladder neck and urethra18.42 wRVU

    Not priced

How to choose

51860Bladder repairSimple wound suture
Use 51860 for simple bladder-wound closure. Use 51865 when the operative record supports a complicated repair.
51880Cystostomy closureExisting urinary opening
51880 addresses closure of a cystostomy tract. 51865 repairs a bladder wound, such as an injury.
51800Bladder outlet reconstructionBladder neck and urethra
51800 is for reconstructive bladder-urethral surgery; 51865 is for repair of a complicated bladder wound.

Codes related to 51865

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

Codes related to 51865
CodeHow it relatesNational office range
Same family
51860Bladder repair, simple wound sutureSibling code for simple, rather than complicated, bladder-wound repair.No office rate
Used instead
51880Cystostomy closure, existing urinary openingUsed for closure of a cystostomy tract, not repair of a bladder wound.No office rate
51800Bladder outlet reconstruction, bladder neck and urethraFor reconstructive bladder-urethral surgery rather than closure of a bladder wound.No office rate

51865 billing questions

How is 51865 distinguished from 51860?

51865 is for a complicated bladder-wound repair; 51860 is for a simple repair. The operative documentation should support the complexity of the work rather than relying on the procedure setting alone.

Can modifier 50 be used for repair of wounds on both sides of the bladder?

No. Modifier 50 is inappropriate for this service; the CMS bilateral adjustment does not apply to this bladder repair.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team-surgery billing is not permitted.

How is 51865 paid when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

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 51865PPRRVU2026_Oct_nonQPP.csv, line 6,094 (RVU26D)

Open CMS sourceHow we calculate rates

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