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CPT code 53605: Urethral dilation, complicated male stricture2026 Medicare rate & RVUs

Reports complicated dilation of a male urethral stricture using a sound or dilator, with documentation supporting the complexity of the procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities156 Medicare services in 2024

Medicare pays $55.78 for 53605 nationally in a facility.

Medicare rate · 53605

Urethral dilation, complicated male stricture

Office or facility?

Work RVUs
1.25
Total RVUs
1.67
Global days
000

National rate · 2026

$55.78

Facility setting, before claim adjustments.

See every locality for 53605 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 53605 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 53605 covers

A urologist dilates a narrowed segment of the male urethra by passing a sound or dilator. The procedure treats a urethral stricture and is reported with this code when the dilation is documented as complicated. It may be performed in an office or facility setting; the patient’s symptoms and the stricture’s location and extent help explain the clinical need for treatment.

Document the male anatomy, stricture, dilation technique, and circumstances supporting the complicated designation. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeon and team-surgery billing 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 53605 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

53605 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$52.37
AlaskaUnavailable$74.82
ArizonaUnavailable$54.74
ArkansasUnavailable$51.96
Atlanta, GAUnavailable$57.12
Austin, TXUnavailable$55.76
Bakersfield, CAUnavailable$55.32
Baltimore area, MDUnavailable$58.35
Beaumont, TXUnavailable$54.62
Brazoria, TXUnavailable$54.86

53605 rates by state

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

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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
53605 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

How the 53605 rate is calculated

Each of 53605’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 · 53605

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.25

1.25 RVUs× 1.000 GPCI

Practice expense0.26

0.26 RVUs× 1.000 GPCI

Malpractice0.16

0.16 RVUs× 1.000 GPCI

Adjusted RVUs

1.6700

Conversion factor

$33.4009

Medicare rate

$55.78

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

Payment rules and modifiers for 53605

The CMS indicators that decide how 53605 is paid alongside other services.

CMS payment indicators · 53605

Urethral dilation, complicated male stricture

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

53605 without 51 · national facility

$55.78

Urethral dilation, complicated male stricture

53605-51 · Second procedure: 50%

$27.89

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%).

When to use modifier 51

53605 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 53605

    Urethral dilation, complicated male stricture1.25 wRVU

    Not priced

  • 53600

    Urethral dilation, male, initial1.18 wRVU

    $91.18

  • 53601

    Urethral dilation, male, subsequent0.96 wRVU

    $89.51

  • 53665

    Urethral dilation, female, complicated0.74 wRVU

    Not priced

How to choose

53600Urethral dilationMale, initial
Use 53600 for initial male urethral stricture dilation when the service is not documented as complicated. Code 53605 is the complicated-service choice.
53601Urethral dilationMale, subsequent
Code 53601 describes subsequent male stricture dilation when it is not complicated; 53605 identifies complicated dilation.
53665Urethral dilationFemale, complicated
Code 53665 is for male urethral dilation without an underlying pathology. Code 53605 requires a urethral stricture and a complicated dilation.

Codes related to 53605

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

Codes related to 53605
CodeHow it relatesNational office range
Same family
53600Urethral dilation, male, initialMale urethral stricture dilation for an initial, noncomplicated service.$82.16–$113.86
53601Urethral dilation, male, subsequentMale urethral stricture dilation for a subsequent, noncomplicated service.$80.04–$114.80
Used instead
53620Urethral dilation, female, initialUrethral stricture dilation for a female patient.$154.34–$226.88
53665Urethral dilation, female, complicatedMale urethral dilation without an underlying stricture.No office rate
53660Urethral dilation, female, requiring physician skillFemale urethral dilation without an underlying pathology.$70.04–$103.59
53661Urethral dilation, female, subsequentFemale urethral dilation with underlying pathology.$68.94–$101.56

53605 billing questions

How is 53605 distinguished from 53600 or 53601?

Code 53605 is for complicated male urethral stricture dilation. Codes 53600 and 53601 describe male stricture dilation distinguished as initial or subsequent.

What documentation supports reporting 53605?

Document the male urethral stricture, the dilation performed, the technique, and the circumstances that make the procedure complicated.

Is same-day postoperative care separately reported?

Same-day preoperative and postoperative care is included in the 0-day global period.

Can modifier 50 be used?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures performed in the same session are subject to the standard multiple procedure reduction.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. 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

Show the CMS file lines behind this rate
RVUs for 53605PPRRVU2026_Oct_nonQPP.csv, line 6,221 (RVU26D)

Open CMS sourceHow we calculate rates

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