CPT code 51900: Fistula repair, vaginal approach2026 Medicare rate & RVUs in North Carolina

In North Carolina, Medicare pays $709.19 for 51900 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 51900 nationwide

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

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.

How North Carolina compares for 51900

Across 109 of 109 payment localities, the facility rate for 51900 runs from $686.24 in Arkansas to $969.38 in Alaska. North Carolina pays $709.19. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

51900 rates by state

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

See 51900 in every payment locality

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.

Payment rules and modifiers for 51900

51900 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 51900

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

How 51900 has changed in North Carolina

Price 51900 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Advance
• Ahoskie
• Alamance
• Albemarle
• Alexis
• Alliance
• Altamahaw

Browse all communities in North Carolina

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

Open CMS sourceHow we calculate rates