CPT code 53451: Balloon device placement, bilateral placement2026 Medicare rate & RVUs in Texas
Reports transperineal placement of a balloon continence device on both sides of the urethra, typically to treat male stress urinary incontinence.
CMS doesn’t publish an office rate for 53451 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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On this page 9 sections
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.
Where 53451 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 | Unavailable |
| Beaumont, TX | Unavailable | Unavailable |
| Brazoria, TX | Unavailable | Unavailable |
| Dallas, TX | Unavailable | Unavailable |
| Fort Worth, TX | Unavailable | Unavailable |
| Galveston, TX | Unavailable | Unavailable |
| Houston, TX | Unavailable | Unavailable |
| Rest of Texas | Unavailable | Unavailable |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
53451 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 53452Continence balloonUnilateral insertion
- Both codes describe transperineal balloon continence device placement. Use 53451 for bilateral placement and 53452 for unilateral placement.
- 53453Balloon device removalEach balloon
- 53453 describes removal of a balloon continence device, not its bilateral placement.
- 53454Balloon device adjustmentTransperineal continence device
- 53454 is for adjustment of a previously placed balloon device; 53451 is for bilateral placement.
- 53445Artificial sphincterInitial inflatable device placement
- 53445 describes implantation of an artificial urinary sphincter, a different device and procedure from balloon continence device placement.
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.
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