CPT code 53620: Urethral dilation, female, initial2026 Medicare rate & RVUs in Missouri
Reports the initial instrument-based widening of a documented female urethral stricture, typically performed by a urologist in an office or outpatient setting.
Medicare pays $157.75–$168.21 for 53620 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
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 53620 covers
A urologist or other qualified physician uses a sound or urethral dilator to widen a narrowed segment of the female urethra. The procedure may be performed in an office or outpatient facility when a urethral stricture is being treated; it is distinct from general female urethral dilation without a stricture-specific service. Documentation should identify the stricture and describe the dilation performed.
Use this code for the initial dilation in the treatment sequence; code 53621 is the subsequent-service counterpart. The record should support that this is the initial service and include the clinical indication and procedural details. CMS assigns 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 not appropriate for this urethral service. CMS does not pay assistant-at-surgery services for this code, and co-surgeon and team-surgery reporting 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 53620 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$157.75 to $168.21
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $166.56 | $75.92 |
| Metropolitan St. Louis, MO | $168.21 | $76.32 |
| Rest of Missouri | $157.75 | $74.54 |
How the 53620 rate is calculated
Each of 53620’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 · 53620
RVUs × geographic indexes × conversion factor
Work1.58
1.58 RVUs× 1.000 GPCI
Practice expense3.42
3.42 RVUs× 1.000 GPCI
Malpractice0.20
0.20 RVUs× 1.000 GPCI
Adjusted RVUs
5.2000
Conversion factor
$33.4009
Medicare rate
$173.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53620
The CMS indicators that decide how 53620 is paid alongside other services.
CMS payment indicators · 53620
Urethral dilation, female, initial
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
53620 without 51 · national office
$173.68
Urethral dilation, female, initial
53620-51 · Second procedure: 50%
$86.84
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%).
53620 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 53621Urethral dilationFemale, subsequent dilation
- Both are female stricture-dilation services; 53620 is the initial service, while 53621 is used for a subsequent dilation.
- 53600Urethral dilationMale, initial
- This is the initial stricture-dilation code for a male patient. Code 53620 is for a female patient.
- 53660Urethral dilationFemale, requiring physician skill
- Code 53620 describes initial dilation in the female urethral stricture series. Code 53660 is from the separate female urethral dilation series.
53620 billing questions
When should 53620 be chosen over 53621?
Use 53620 for the initial female urethral stricture dilation in the treatment sequence. Use 53621 for a subsequent dilation.
How is this different from 53660?
Code 53620 is for initial dilation of a documented female urethral stricture. Code 53660 belongs to the female urethral dilation series outside this stricture-specific sequence.
Can modifier 50 be reported?
No. This urethral service is not reported as a bilateral procedure.
Is same-day evaluation and postoperative care separately included?
The code has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant-at-surgery service for this code. Co-surgeon and team-surgery reporting are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard multiple-procedure reduction.
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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