CPT code 51865: Bladder wound repair, complicated repair2026 Medicare rate & RVUs in Texas
Report complicated surgical closure of a bladder wound, such as a bladder injury requiring more involved repair than a simple wound closure.
CMS doesn’t publish an office rate for 51865 in Texas.
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
On this page 9 sections
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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $815.43 |
| Beaumont, TX | Unavailable | $784.80 |
| Brazoria, TX | Unavailable | $795.86 |
| Dallas, TX | Unavailable | $803.24 |
| Fort Worth, TX | Unavailable | $801.98 |
| Galveston, TX | Unavailable | $799.84 |
| Houston, TX | Unavailable | $840.29 |
| Rest of Texas | Unavailable | $791.52 |
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
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
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 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.
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%).
51865 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
Fee sheets · Coming soon
Put 51865 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist