CPT code 51925: Fistula repair, with hysterectomy2026 Medicare rate & RVUs in Illinois
Abdominal closure of a bladder-to-uterus fistula performed with hysterectomy, reported when both the fistula repair and uterine removal are part of the operation.
CMS doesn’t publish an office rate for 51925 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 51925 covers
51925 describes abdominal surgery to close an abnormal tract connecting the bladder and uterus when the operation also removes the uterus. The tract may follow prior uterine surgery, including cesarean delivery; the surgeon separates the bladder from the uterus, closes the communication, and performs hysterectomy. A gynecologic surgeon, urologist, or surgeons working together may perform the operation in a hospital operating room. This service differs from repairing a bladder-vaginal fistula or a bladder defect without a uterine connection.
Report the code when the operative documentation establishes the vesicouterine fistula, abdominal approach, closure, and hysterectomy as part of the operation; the hysterectomy is included in this service. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, CMS pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 51925 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 | $1,080.71 |
| East St. Louis, IL | Unavailable | $1,025.22 |
| Rest of Illinois | Unavailable | $978.11 |
| Suburban Chicago, IL | Unavailable | $1,034.34 |
How the 51925 rate is calculated
Each of 51925’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 · 51925
RVUs × geographic indexes × conversion factor
Work17.09
17.09 RVUs× 1.000 GPCI
Practice expense8.22
8.22 RVUs× 1.000 GPCI
Malpractice3.00
3.00 RVUs× 1.000 GPCI
Adjusted RVUs
28.3100
Conversion factor
$33.4009
Medicare rate
$945.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 51925
51925 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 51925
Fistula repair, with hysterectomy
| 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 · 51925
Fistula repair, with hysterectomy
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
51925 without 51 · national facility
$945.58
Fistula repair, with hysterectomy
51925-51 · Second procedure: 50%
$472.79
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%).
51925 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 51920Fistula repairBladder-to-uterus connection
- Choose 51925 when hysterectomy accompanies abdominal closure of the vesicouterine fistula. Choose 51920 when the fistula is closed without hysterectomy.
- 51900Fistula repairVaginal approach
- 51900 concerns a vesicovaginal fistula, connecting the bladder and vagina. 51925 is for a bladder-to-uterus fistula closed with hysterectomy.
- 58150HysterectomyAbdominal, cervix removed
- 58150 describes abdominal hysterectomy without the vesicouterine fistula closure represented by 51925. When both are performed as the 51925 service, the hysterectomy is included.
51925 billing questions
How does 51925 differ from 51920?
Both describe abdominal closure of a vesicouterine fistula. Use 51925 when hysterectomy is performed as part of the fistula operation; 51920 describes closure without hysterectomy.
Can the hysterectomy be reported separately?
The hysterectomy is included in 51925 when it is performed as part of the vesicouterine fistula operation. Do not report a separate hysterectomy code for that same work.
Should modifier 50 be appended?
No. CMS specifies that bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What happens when other procedures are performed in the same session?
CMS pays the highest-valued procedure in full and reduces the other procedures to 50%. 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?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and 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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