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CPT code 53451: Balloon device placement, bilateral placement2026 Medicare rate & RVUs in Idaho

Reports transperineal placement of a balloon continence device on both sides of the urethra, typically to treat male stress urinary incontinence.

CMS RVU26DEffective Oct 1, 2026One payment locality267 Medicare services in 2024

CMS doesn’t publish a rate for 53451 in Idaho.

Contractor-pricedOffice (non-facility)
Contractor-pricedHospital or facility

Check a contract rate as a % of Medicare · 53451 nationwide

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

We’ll open 53451 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Idaho
  2. What 53451 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 53451 covers

A urologist places a balloon continence device through the perineum, positioning balloons alongside the urethra to support urinary continence. The bilateral procedure is used for stress urinary incontinence, including in men with persistent leakage after prostate treatment. It is generally performed in a surgical setting; the balloons can be adjusted after placement as clinically needed.

Medicare lists this CPT Category I service as carrier priced, status C: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The bilateral placement is reported with this code; modifier 50 is not appropriate. Medicare assigns a 10-day global period, which includes related postoperative visits during that period. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are 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.

How Idaho compares for 53451

53451 in Idaho vs other payment areas
  1. Idaho · this pageUnavailable
  2. Los Angeles, CA · CaliforniaUnavailable
  3. Washington, DC area · District of ColumbiaUnavailable
  4. Miami, FL · FloridaUnavailable
  5. Chicago, IL · IllinoisUnavailable
  6. Manhattan, NY · New YorkUnavailable
  7. Alaska · AlaskaUnavailable

Other areas in Idaho first, then benchmark localities. Bars start at $0.

Every other payment area

53451 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama——
ArkansasArkansas——
ArizonaArizona——
Bakersfield, CACalifornia——
Chico, CACalifornia——
El Centro, CACalifornia——
Fresno, CACalifornia——
Hanford, CACalifornia——

53451 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
53451 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 53451 in every payment locality

How the 53451 rate is calculated

Each of 53451’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 · 53451

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 53451

53451 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 53451

Balloon device placement, bilateral placement

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 53451

Balloon device placement, bilateral placement

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

Codes related to 53451

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

Codes related to 53451
CodeHow it relatesOffice range, Idaho
Used instead
53452Continence balloon, unilateral insertionUnilateral placement of a balloon continence device when only one side is treated.No office rate
53440Male sling, male stress incontinenceMale sling surgery is another surgical approach to male stress urinary incontinence.No office rate
53445Artificial sphincter, initial inflatable device placementArtificial urinary sphincter implantation is another surgical treatment for urinary incontinence.No office rate
Same family
53453Balloon device removal, each balloonCode for removal of a balloon continence device.No office rate
53454Balloon device adjustment, transperineal continence deviceCode for adjustment of a previously placed balloon continence device.No office rate

How 53451 has changed in Idaho

53451 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2022

    RVU22A

    No ratechanged toNo rate

    Held through RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.

  2. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Contractor-pricedContractor-pricedRVU26D
2026-07-01Contractor-pricedContractor-pricedRVU26C
2026-04-01Contractor-pricedContractor-pricedRVU26B
2026-01-01Contractor-pricedContractor-pricedRVU26A
2025-10-01Contractor-pricedContractor-pricedRVU25D
2025-07-01Contractor-pricedContractor-pricedRVU25C
2025-04-01Contractor-pricedContractor-pricedRVU25B
2025-01-01Contractor-pricedContractor-pricedRVU25A
2024-10-01Contractor-pricedContractor-pricedRVU24D
2024-07-01Contractor-pricedContractor-pricedRVU24C
2024-04-01Contractor-pricedContractor-pricedRVU24B
2024-03-09Contractor-pricedContractor-pricedRVU24AR
2024-01-01Contractor-pricedContractor-pricedRVU24A
2023-10-01Contractor-pricedContractor-pricedRVU23D
2023-07-01Contractor-pricedContractor-pricedRVU23C
2023-04-01Contractor-pricedContractor-pricedRVU23B
2023-01-01Contractor-pricedContractor-pricedRVU23A
2022-10-01Contractor-pricedContractor-pricedRVU22D
2022-07-01Contractor-pricedContractor-pricedRVU22C
2022-04-01Contractor-pricedContractor-pricedRVU22B
2022-01-01Contractor-pricedContractor-pricedRVU22A
2021-10-01Not in this releaseNot in this releaseRVU21D
2021-07-01Not in this releaseNot in this releaseRVU21C
2021-04-01Not in this releaseNot in this releaseRVU21B
2021-01-01Not in this releaseNot in this releaseRVU21A
2020-10-01Not in this releaseNot in this releaseRVU20D
2020-07-01Not in this releaseNot in this releaseRVU20C
2020-04-01Not in this releaseNot in this releaseRVU20B
2020-01-01Not in this releaseNot in this releaseRVU20A
2019-10-01Not in this releaseNot in this releaseRVU19D
2019-07-01Not in this releaseNot in this releaseRVU19C
2019-04-01Not in this releaseNot in this releaseRVU19B
2019-01-01Not in this releaseNot in this releaseRVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 53451 for an earlier date of service

Where the Idaho rate applies

Idaho is a Medicare payment area, not a city. Our Census mapping connects it to 235 cities and communities in Idaho. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Acequia
  • Albion
  • American Falls
  • Ammon
  • Arbon Valley
  • Arco
  • Arimo

Browse all communities in Idaho

53451 billing questions

When should this code be used instead of 53452?

Use 53451 for bilateral balloon placement. Code 53452 is the unilateral placement code.

Should modifier 50 be appended?

No. This code represents bilateral placement, and modifier 50 is inappropriate.

Which codes identify adjustment or removal?

Code 53454 identifies adjustment, and 53453 identifies removal. Code 53451 identifies bilateral placement.

How does Medicare price this service?

It has physician fee schedule status C, or carrier priced. The Medicare Administrative Contractor sets payment for each claim; CMS publishes no national payment.

Are related postoperative visits included?

Related postoperative visits during the 10-day global period are included.

Can an assistant or co-surgeon be reported?

An assistant at surgery is paid only with documentation of medical necessity. Co-surgeons and team surgery are not permitted.

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

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