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Billing code 51520: Bladder diverticulectomyMedicare rate & RVUs

Report 51520 for open excision of one or more bladder diverticula through cystotomy, rather than for tumor removal or partial cystectomy.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $544.43 for 51520 nationally in a facility.

Medicare rate · 51520

Bladder diverticulectomy

Work RVUs
9.95
Total RVUs
16.30
Global days
090

National rate · 2026

$544.43

Facility setting, before claim adjustments.

See every locality for 51520 →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 51520 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 51520 covers

51520 represents an open bladder operation in which the surgeon enters the bladder through a cystotomy and removes one or more bladder diverticula. A diverticulum is an outpouching of the bladder wall; this service is distinct from transurethral removal of an intravesical tumor. Urologists typically perform it in an operating room when operative excision of the diverticulum is planned.

Choose 51520 when the operative work is excision of bladder diverticulum through cystotomy, whether one or multiple diverticula are removed. The operative report should identify the diverticulum or diverticula and describe the cystotomy and excision, distinguishing the service from tumor removal or a broader partial cystectomy. CMS assigns a 90-day major-surgery global period: the day-before preoperative visit and 90 days of related postoperative care are included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; 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 51520 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

51520 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$504.61
Alaska*Unavailable$702.24
ArizonaUnavailable$532.99
ArkansasUnavailable$499.71
AtlantaUnavailable$556.80
AustinUnavailable$549.99
BakersfieldUnavailable$550.13
Baltimore/Surr. CntysUnavailable$572.30
BeaumontUnavailable$526.16
BrazoriaUnavailable$536.09

51520 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
51520 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 51520 rate is calculated

Each of 51520’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 · 51520

RVUs × geographic indexes × conversion factor

Work9.95

9.95 RVUs× 1.000 GPCI

Practice expense5.06

5.06 RVUs× 1.000 GPCI

Malpractice1.29

1.29 RVUs× 1.000 GPCI

Adjusted RVUs

16.3000

Conversion factor

$33.4009

Medicare rate

$544.43

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

Payment rules and modifiers for 51520

51520 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 51520

Bladder diverticulectomy

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 · 51520

Bladder diverticulectomy

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

51520 without 51 · national facility

$544.43

Bladder diverticulectomy

51520-51 · Second procedure: 50%

$272.22

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

51520 compared with similar codes

Compare codes · National

5 codes, side by side

  • 51520

    Bladder diverticulectomy9.95 wRVU

    Not priced

  • 51525

    Bladder surgery15.03 wRVU

    Not priced

  • 51530

    Bladder tumor excision13.37 wRVU

    Not priced

  • 51550

    Partial cystectomy16.8 wRVU

    Not priced

  • 51555

    Partial cystectomy22.6 wRVU

    Not priced

How to choose

51525Bladder surgery
51520 describes excision of a bladder diverticulum. Choose 51525 when the cystotomy is performed to remove a bladder tumor.
51530Bladder tumor excision
51530 is for bladder tumor excision that includes partial cystectomy. 51520 is for diverticulum excision, not tumor removal with bladder resection.
51550Partial cystectomy
51550 describes simple partial cystectomy. Use 51520 when the documented operation is excision of one or more diverticula through cystotomy.
51555Partial cystectomy
51555 describes complicated partial cystectomy. It is not the diverticulectomy service represented by 51520.

Codes related to 51520

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

Codes related to 51520
CodeHow it relatesNational office range
Used instead
51525Bladder surgeryCystotomy for bladder tumor excision rather than diverticulum excision.No office rate
51530Bladder tumor excisionBladder tumor excision with partial cystectomy, rather than diverticulectomy.No office rate
51550Partial cystectomyPartial cystectomy when the operative service is bladder resection rather than diverticulum excision.No office rate
51555Partial cystectomyComplicated partial cystectomy rather than excision of a bladder diverticulum.No office rate

51520 billing questions

When should 51520 be used instead of 51525?

Use 51520 for excision of a bladder diverticulum through cystotomy. Use 51525 when the cystotomy is for excision of a bladder tumor.

Is each diverticulum reported as a separate unit?

No. The code covers excision of a single diverticulum or multiple diverticula; the number removed alone does not establish separate units.

Does the 90-day global period include postoperative care?

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

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is 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 51520PPRRVU2026_Oct_nonQPP.csv, line 6,027 (RVU26D)

Open CMS sourceHow we calculate rates

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