CPT code 51900: Fistula repair, vaginal approach2026 Medicare rate & RVUs in Illinois
Reports vaginal-route surgical closure of a communication between the bladder and vagina, commonly performed for persistent urinary leakage through the vagina.
CMS doesn’t publish an office rate for 51900 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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On this page 9 sections
What 51900 covers
This operation closes a vesicovaginal fistula through the vagina. The surgeon identifies and separates the bladder and vaginal sides of the abnormal opening, then closes the defect. It is commonly performed by a urologist, urogynecologist, or gynecologic surgeon when a patient has ongoing urine leakage into the vagina, often after pelvic surgery or an obstetric injury. The service is generally performed in an operating room rather than an office setting.
Report 51900 when the documented fistula is between the bladder and vagina and the repair uses the vaginal route. The operative report should support the fistula location, the approach, and the closure performed; an uncomplicated vaginal injury without a bladder fistula is a different service. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. 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. Assistant-at-surgery payment may be made; co-surgeon payment requires 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 51900 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 | $828.70 |
| East St. Louis, IL | Unavailable | $790.53 |
| Rest of Illinois | Unavailable | $761.51 |
| Suburban Chicago, IL | Unavailable | $801.30 |
How the 51900 rate is calculated
Each of 51900’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 · 51900
RVUs × geographic indexes × conversion factor
Work14.26
14.26 RVUs× 1.000 GPCI
Practice expense6.22
6.22 RVUs× 1.000 GPCI
Malpractice1.83
1.83 RVUs× 1.000 GPCI
Adjusted RVUs
22.3100
Conversion factor
$33.4009
Medicare rate
$745.17
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 51900
51900 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 51900
Fistula repair, vaginal approach
| 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 · 51900
Fistula repair, vaginal approach
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
51900 without 51 · national facility
$745.17
Fistula repair, vaginal approach
51900-51 · Second procedure: 50%
$372.59
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%).
51900 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 51925Fistula repairWith hysterectomy
- Both codes address vesicovaginal fistula closure. Choose 51900 for the vaginal route and 51925 for the abdominal route, with or without hysterectomy.
- 51920Fistula repairBladder-to-uterus connection
- This code concerns a fistula between the bladder and uterus. Code 51900 is for a bladder-to-vagina communication.
- 57200Vaginal repairNonobstetric injury
- This code is for repair of a nonobstetrical vaginal injury. Use 51900 when the operation closes a vesicovaginal fistula, not an isolated vaginal injury.
51900 billing questions
When should 51900 be selected instead of 51925?
Use 51900 for closure of a vesicovaginal fistula through the vaginal route. Code 51925 describes the abdominal approach and includes the possibility of hysterectomy.
Is a vaginal laceration repair reported with 51900?
Not when there is no communication between the bladder and vagina. A nonobstetrical vaginal injury repair is a different service; the operative findings should establish whether a fistula was repaired.
Can modifier 50 be used for a fistula on each side?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care. Separate procedures during the same session are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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
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