CPT code 53415: Urethroplasty, one-stage, transpubic or perineal2026 Medicare rate & RVUs in Texas
Reports a one-stage urethral reconstruction performed through a transpubic or perineal approach to treat urethral stricture or atresia.
CMS doesn’t publish an office rate for 53415 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.
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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 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 | $1,017.30 |
| Beaumont, TX | Unavailable | $982.67 |
| Brazoria, TX | Unavailable | $995.34 |
| Dallas, TX | Unavailable | $1,004.07 |
| Fort Worth, TX | Unavailable | $1,002.70 |
| Galveston, TX | Unavailable | $1,000.03 |
| Houston, TX | Unavailable | $1,047.80 |
| Rest of Texas | Unavailable | $990.16 |
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.
How the rate is built · 53415
RVUs × geographic indexes × conversion factor
Work20.18
20.18 RVUs× 1.000 GPCI
Practice expense7.49
7.49 RVUs× 1.000 GPCI
Malpractice2.61
2.61 RVUs× 1.000 GPCI
Adjusted RVUs
30.2800
Conversion factor
$33.4009
Medicare rate
$1,011.38
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53415
53415 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53415
Urethroplasty, one-stage, transpubic or perineal
| 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 · 53415
Urethroplasty, one-stage, transpubic or perineal
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
53415 without 51 · national facility
$1,011.38
Urethroplasty, one-stage, transpubic or perineal
53415-51 · Second procedure: 50%
$505.69
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%).
53415 compared with similar codes
Compare codes · National
5 codes, side by side
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.
53415 billing questions
How does 53415 differ from 53410?
53415 identifies a one-stage repair performed through a transpubic or perineal approach for urethral stricture or atresia. Code 53410 describes one-stage reconstruction of the male posterior urethra; follow the documented procedure and applicable code descriptor.
When should a two-stage reconstruction code be considered instead?
Use a two-stage reconstruction code when the operative plan is staged rather than completed in one operation. The record should make the staged plan and the work performed at the current operation clear.
Should modifier 50 be appended for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What postoperative care is included in the global period?
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, while team surgery is not permitted.
How is 53415 paid when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and the other procedure or procedures are subject to the standard 50% multiple-procedure reduction.
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
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