CPT code 53425: Urethral reconstruction, second stage2026 Medicare rate & RVUs in Maryland
Reports the second operation in a planned two-stage male urethral reconstruction, commonly completing a staged repair for hypospadias.
CMS doesn’t publish an office rate for 53425 in Maryland.
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 53425 covers
This code represents the second operation in a planned two-stage male urethral reconstruction. The surgeon completes the urethral channel using tissue prepared during the first stage, often by tubularizing that tissue. A common context is staged repair of hypospadias or another urethral defect requiring reconstruction. A urologist or reconstructive surgeon typically performs the procedure in an operating room.
Report the code when the documented service is the second stage of the reconstruction, not the initial stage or a one-stage repair. The operative report should identify the staged plan, the prior first-stage work, and the reconstruction performed at this operation. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. 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 53425 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $881.04 |
| Rest of Maryland | Unavailable | $841.94 |
| Washington, DC area | Unavailable | $915.60 |
How the 53425 rate is calculated
Each of 53425’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 · 53425
RVUs × geographic indexes × conversion factor
Work16.64
16.64 RVUs× 1.000 GPCI
Practice expense6.36
6.36 RVUs× 1.000 GPCI
Malpractice2.14
2.14 RVUs× 1.000 GPCI
Adjusted RVUs
25.1400
Conversion factor
$33.4009
Medicare rate
$839.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53425
53425 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53425
Urethral reconstruction, second stage
| 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 · 53425
Urethral reconstruction, second stage
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
53425 without 51 · national facility
$839.70
Urethral reconstruction, second stage
53425-51 · Second procedure: 50%
$419.85
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%).
53425 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 53420Urethral reconstructionFirst stage
- 53420 is for the first operation in a two-stage urethral reconstruction; 53425 is for the second operation that completes it.
- 53410Urethral reconstructionMale anterior, one-stage
- 53410 describes a one-stage male urethral reconstruction. Use 53425 when the reconstruction is performed as the second stage of a planned staged repair.
- 53405UrethroplastySecond stage, male anterior
- 53405 is associated with staged urethroplasty for congenital or acquired urethral stricture; 53425 describes the second stage of urethral reconstruction, such as for hypospadias.
53425 billing questions
How is this code distinguished from 53420?
53420 reports the first stage of a two-stage urethral reconstruction. Use 53425 for the subsequent operation that completes the reconstruction.
Is 53425 the second stage for every staged urethroplasty?
No. This code is for staged urethral reconstruction, such as a hypospadias repair. Code 53405 is associated with staged urethroplasty for congenital or acquired urethral stricture.
Can 53425 be reported for a one-stage reconstruction?
No. A reconstruction performed as a single-stage procedure is represented by a different code, such as 53410 when its criteria are met.
What documentation supports reporting the second stage?
Document the planned two-stage reconstruction, the prior first-stage procedure, and the operative work that completes the urethral reconstruction.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session handled?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation.
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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