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CPT 51940: Bladder repairMedicare rate & RVUs

Reports surgical reconstruction of bladder exstrophy, including correction of the exposed bladder defect, with or without an osteotomy.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,456.95 for 51940 nationally in a facility.

Medicare rate · 51940

Bladder repair

Swap in your local Medicare rate.

Work RVUs
29.89
Total RVUs
43.62
Global days
090

National rate · 2026

$1,456.95

Facility setting, before claim adjustments.

See every locality for 51940 →

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 9 sections
  1. Medicare rate
  2. What 51940 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Billing questions
  9. Sources

What 51940 covers

This code describes operative correction of bladder exstrophy, a congenital defect in which the bladder is exposed through an opening in the lower abdominal wall. Reconstruction addresses the bladder defect and its associated abdominal-wall opening; an osteotomy may be part of the operation. Pediatric urologists typically perform the procedure in a hospital operating room, often as part of a planned reconstructive course.

Report 51940 when the operative service is correction of bladder exstrophy, rather than closure of a fistula or repair of a bladder-vaginal lesion. The operative report should identify the exstrophy and describe the reconstruction, including whether an osteotomy was performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is not appropriate for this procedure.

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 51940 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

51940 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,359.89
Alaska*Unavailable$1,919.84
ArizonaUnavailable$1,428.20
ArkansasUnavailable$1,348.05
AtlantaUnavailable$1,491.07
AustinUnavailable$1,463.42
BakersfieldUnavailable$1,457.32
Baltimore/Surr. CntysUnavailable$1,527.49
BeaumontUnavailable$1,418.12
BrazoriaUnavailable$1,433.67

51940 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
51940 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 51940 rate is calculated

Each of 51940’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 · 51940

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 29.89Practice expense 9.88Malpractice 3.85

43.6200 adjusted RVUs×$33.4009 conversion factor=$1,456.95

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

Payment rules and modifiers for 51940

51940 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 51940

Bladder repair

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 · 51940

Bladder repair

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

51940 without 51 · national facility

$1,456.95

Bladder repair

51940-51 · Second procedure: 50%

$728.48

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

51940 compared with similar codes

Compare codes

51940 vs 51900 vs 51920 vs 51925: national Medicare rates

Swap in your local Medicare rate.

  • 51940
    Bladder repair · 29.89 wRVU
    —
  • 51900
    Fistula repair · 14.26 wRVU
    —
  • 51920
    Fistula repair · 13.07 wRVU
    —
  • 51925
    Fistula repair · 17.09 wRVU
    —

How to choose

51900Fistula repair
51900 addresses a bladder-vaginal lesion. Choose 51940 when the operative diagnosis is bladder exstrophy rather than a lesion involving the bladder and vagina.
51920Fistula repair
51920 is for closure of a bladder-uterus fistula. It does not describe reconstruction of bladder exstrophy.
51925Fistula repair
51925 concerns bladder repair associated with hysterectomy, rather than correction of a congenital bladder exstrophy defect.

51940 billing questions

When should 51940 be selected instead of a bladder fistula repair code?

Use 51940 for correction of bladder exstrophy. Codes for vesicovaginal or vesicouterine fistula repair address abnormal connections between organs, not the congenital exstrophy defect.

Does the code include an osteotomy when one is performed?

The service is described as correction of bladder exstrophy with or without osteotomy. Document whether an osteotomy was performed as part of the reconstruction.

What postoperative care is included?

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

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How does Medicare handle other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

Should modifier 50 be used?

No. Modifier 50 is inappropriate for this bladder exstrophy correction.

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 51940PPRRVU2026_Oct_nonQPP.csv, line 6,099 (RVU26D)

Open CMS sourceHow we calculate rates

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