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Billing code 51040: Bladder drainageMedicare rate & RVUs

Open bladder incision with drainage establishes a surgical route for urine when bladder emptying cannot be managed reliably through the urethra.

CMS RVU26DEffective Oct 1, 2026109 payment localities4.2K Medicare services in 2024

Medicare pays $272.89 for 51040 nationally in a facility.

Medicare rate · 51040

Bladder drainage

Swap in your local Medicare rate.

Work RVUs
4.38
Total RVUs
8.17
Global days
090

National rate · 2026

$272.89

Facility setting, before claim adjustments.

See every locality for 51040 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 51040 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 51040 covers

This service is an open surgical entry into the urinary bladder to establish drainage, commonly through a suprapubic route when urine cannot be drained safely or reliably through the urethra. A urologist typically performs it in an operating room, such as when outlet obstruction or urethral injury makes transurethral catheter placement unsuitable. The operative work includes opening the bladder and providing a route for urine to drain; it is not simply percutaneous catheter placement.

Report 51040 when the operative note supports an open cystotomy performed for bladder drainage. Document the indication, surgical approach, bladder entry, and drainage arrangement. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are paid at 50%. CMS may pay an assistant at surgery; 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 51040 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

51040 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$251.28
Alaska*Unavailable$344.65
ArizonaUnavailable$266.85
ArkansasUnavailable$248.60
AtlantaUnavailable$278.81
AustinUnavailable$277.30
BakersfieldUnavailable$278.71
Baltimore/Surr. CntysUnavailable$287.53
BeaumontUnavailable$261.85
BrazoriaUnavailable$268.97

51040 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
51040 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 51040 rate is calculated

Each of 51040’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 · 51040

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.38Practice expense 3.23Malpractice 0.56

8.1700 adjusted RVUs×$33.4009 conversion factor=$272.89

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 51040

51040 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 51040

Bladder drainage

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.08/0.83/0.09Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 51040

Bladder drainage

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

51040 without 51 · national facility

$272.89

Bladder drainage

51040-51 · Second procedure: 50%

$136.45

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

51040 compared with similar codes

Compare codes

51040 vs 51102 vs 51045 vs 51080: national Medicare rates

Swap in your local Medicare rate.

  • 51040
    Bladder drainage · 4.38 wRVU
    —
  • 51102
    Bladder drainage · 2.63 wRVU
    $241.15
  • 51045
    Cystotomy · 7.61 wRVU
    —
  • 51080
    Bladder abscess drainage · 6.54 wRVU
    —

How to choose

51102Bladder drainage
51102 is for percutaneous suprapubic catheter placement; 51040 involves open surgical entry into the bladder for drainage.
51045Cystotomy
Choose 51045 when the open bladder procedure includes ureteral catheter work. Choose 51040 for open bladder drainage.
51080Bladder abscess drainage
51080 describes drainage of a bladder abscess. 51040 establishes drainage from the bladder itself, rather than treating an abscess.

Codes related to 51040

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

Codes related to 51040
CodeHow it relatesNational office range
Same family
51045CystotomyOpen cystotomy code distinguished by ureteral catheter work rather than bladder drainage.No office rate
51020Bladder fulgurationCystotomy code for treatment involving bladder fulguration or resection, not drainage alone.No office rate
51050Bladder stone removalCystotomy-family procedure that adds removal of a bladder calculus.No office rate

51040 billing questions

How does 51040 differ from percutaneous suprapubic catheter placement?

51040 describes open surgical access to the bladder for drainage. Use 51102 when the suprapubic catheter is placed percutaneously rather than through an open cystotomy.

When is 51045 a better fit?

51045 involves cystotomy with ureteral catheter work. 51040 is for open bladder access to establish bladder drainage.

What documentation supports 51040?

The operative report should establish the need for drainage and describe the open approach, bladder entry, and drainage arrangement.

How does the 90-day global period affect postoperative care?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

How are multiple procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures in the session are paid at 50%. CMS may pay an assistant at surgery; co-surgeon payment requires supporting documentation.

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 51040PPRRVU2026_Oct_nonQPP.csv, line 6,017 (RVU26D)

Open CMS sourceHow we calculate rates

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