CPT code 53415: Urethroplasty, one-stage, transpubic or perineal2026 Medicare rate & RVUs

Medicare pays $1,011.38 for 53415 nationally in a facility.

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

What 53415 covers

A reconstructive urologist uses this code for a one-stage urethroplasty performed through a transpubic or perineal approach to address urethral stricture or atresia. The operation restores urethral continuity or patency; it is distinct from a planned two-stage reconstruction. These repairs are generally performed in a hospital operating room, often for complex narrowing or obliteration that requires an open reconstructive approach.

Select the code from the operative report’s documented approach, one-stage plan, and urethral condition—not simply from the diagnosis of stricture. The note should describe the reconstruction and the route used. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 53415 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

53415 rates by state

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

How the 53415 rate is calculated

Each of 53415’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 53415

53415 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

53415 compared with similar codes

How to choose

53410Urethral reconstructionMale anterior, one-stage

53410 describes one-stage reconstruction of the male posterior urethra. Code 53415 is selected for a one-stage transpubic or perineal urethroplasty for stricture or atresia.

53420Urethral reconstructionFirst stage

53420 is for a two-stage reconstruction of the male anterior urethra; 53415 describes a one-stage transpubic or perineal repair.

53425Urethral reconstructionSecond stage

53425 is for a two-stage reconstruction of the male posterior urethra. Choose 53415 when the documented operation is the specified one-stage transpubic or perineal repair.

53400Urethral repairStage one

53400 describes one-stage reconstruction of the male anterior urethra. Code 53415 is distinguished by its transpubic or perineal approach and stricture-or-atresia indication.

Codes related to 53415

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

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