CPT code 53446: Sphincter removal, complete device removal2026 Medicare rate & RVUs in Maine
Reports surgical removal of an implanted artificial urinary sphincter, such as for device infection, erosion, or failure, without replacement during the procedure.
CMS doesn’t publish an office rate for 53446 in Maine.
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 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 in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | Unavailable | $555.27 |
| Southern Maine, ME | Unavailable | $568.66 |
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.
How the rate is built · 53446
RVUs × geographic indexes × conversion factor
Work10.74
10.74 RVUs× 1.000 GPCI
Practice expense5.47
5.47 RVUs× 1.000 GPCI
Malpractice1.37
1.37 RVUs× 1.000 GPCI
Adjusted RVUs
17.5800
Conversion factor
$33.4009
Medicare rate
$587.19
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53446
53446 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53446
Sphincter removal, complete device removal
| 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 · 53446
Sphincter removal, complete device removal
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
53446 without 51 · national facility
$587.19
Sphincter removal, complete device removal
53446-51 · Second procedure: 50%
$293.60
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%).
53446 compared with similar codes
Compare codes · National
5 codes, side by side
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.
53446 billing questions
When should this code be used instead of 53447?
Use 53446 when the implanted sphincter is removed without replacement. Code 53447 describes removal and replacement of the sphincter system.
How does this differ from 53448?
53448 is for removal and replacement of sphincter components. This code describes removal without replacement.
Can removal and a new sphincter insertion be reported separately?
When a sphincter is removed and replaced during the same procedure, use the applicable removal-and-replacement code rather than reporting removal and insertion separately.
What documentation supports reporting this code?
The operative report should identify the artificial urinary sphincter, document the removal performed, and state the reason for explantation, such as infection, erosion, or device failure.
Can modifier 50 be used for bilateral removal?
No. Modifier 50 is inappropriate for this code based on the descriptor or anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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