CPT code 53446: Sphincter removal, complete device removal2026 Medicare rate & RVUs

Medicare pays $587.19 for 53446 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 53446 covers

A urologist removes an implanted inflatable urinary sphincter used to manage incontinence, commonly after prostate surgery. The device includes components such as a urethral cuff, pump, and fluid reservoir. Removal may be needed when the system is infected, eroded, malfunctioning, or otherwise requires explantation. This is generally performed in a facility operating room rather than an office setting.

Report this code when the documented operation removes the sphincter system without replacing it. The operative report should identify the device and describe the components removed and the reason for removal; use a removal-and-replacement code when a new system or components are implanted during the procedure. 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, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate for this service. 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 53446 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

53446 rates by state

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

How the 53446 rate is calculated

Each of 53446’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 53446

53446 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

53446 compared with similar codes

How to choose

53445Artificial sphincterInitial inflatable device placement

53445 reports placement of an inflatable urinary sphincter. Use 53446 for removal of an existing system without replacement.

53447Sphincter replacementComplete device

53447 includes removal and replacement of the sphincter system. Use 53446 when no replacement is performed.

53448Sphincter replacementComponent removal and replacement

53448 describes removal and replacement of sphincter components. This code is for removal without component replacement.

53449Sphincter repairUrinary sphincter

53449 describes repair of a urinary sphincter. Choose 53446 when the operation removes the device instead of repairing it.

Codes related to 53446

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