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Billing code 51990: Urethral suspensionMedicare rate & RVUs

Laparoscopic urethral suspension treats stress urinary incontinence by elevating periurethral support tissues and is reported when that operation is performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.4K Medicare services in 2024

Medicare pays $671.02 for 51990 nationally in a facility.

Medicare rate · 51990

Urethral suspension

Swap in your local Medicare rate.

Work RVUs
13.03
Total RVUs
20.09
Global days
090

National rate · 2026

$671.02

Facility setting, before claim adjustments.

See every locality for 51990 → · 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 51990 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 51990 covers

51990 describes laparoscopic suspension of urethral support tissues to treat stress urinary incontinence, commonly using a Burch-type colposuspension. Through abdominal ports, the surgeon places sutures in tissue beside the urethra and secures it to pelvic support structures, elevating support at the bladder neck. Urologists and urogynecologists typically perform the procedure in an operating room under anesthesia for patients with leakage during coughing, exertion, or sneezing.

Select this code for laparoscopic urethral suspension, not a laparoscopic graft or synthetic sling operation (51992). The operative report should establish the laparoscopic approach, suspension technique, and tissues fixed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. When other procedures occur in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard 50% multiple-procedure reduction. Do not use modifier 50; this is a single suspension service, not a paired-side procedure. Assistant-at-surgery payment may be available; 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 51990 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

51990 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$623.90
Alaska*Unavailable$874.60
ArizonaUnavailable$657.26
ArkansasUnavailable$618.13
AtlantaUnavailable$686.67
AustinUnavailable$675.75
BakersfieldUnavailable$674.12
Baltimore/Surr. CntysUnavailable$704.57
BeaumontUnavailable$650.89
BrazoriaUnavailable$660.33

51990 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
51990 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 51990 rate is calculated

Each of 51990’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 · 51990

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.03Practice expense 5.35Malpractice 1.71

20.0900 adjusted RVUs×$33.4009 conversion factor=$671.02

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

Payment rules and modifiers for 51990

51990 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 51990

Urethral suspension

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 · 51990

Urethral suspension

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

51990 without 51 · national facility

$671.02

Urethral suspension

51990-51 · Second procedure: 50%

$335.51

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

51990 compared with similar codes

Compare codes

51990 vs 51992 vs 57288 vs 51715: national Medicare rates

Swap in your local Medicare rate.

  • 51990
    Urethral suspension · 13.03 wRVU
    —
  • 51992
    Urinary sling · 14.5 wRVU
    —
  • 57288
    Sling procedure · 11.83 wRVU
    —
  • 51715
    Urethral bulking · 3.64 wRVU
    $346.37

How to choose

51992Urinary sling
Choose 51990 for laparoscopic urethral suspension, commonly a Burch-type colposuspension; choose 51992 for a laparoscopic sling operation.
57288Sling procedure
Both address stress urinary incontinence with suspension or sling support, but 57288 describes a sling operation performed by a nonlaparoscopic approach.
51715Urethral bulking
51715 describes urethral bulking by injection, not laparoscopic elevation and fixation of urethral support tissues.

Codes related to 51990

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

Codes related to 51990
CodeHow it relatesNational office range
Used instead
51992Urinary slingLaparoscopic sling operation for stress incontinence, rather than urethral suspension.No office rate
57288Sling procedureSling operation for stress incontinence using a nonlaparoscopic approach.No office rate
51715Urethral bulkingUrethral bulking injection is a different procedural treatment for stress incontinence.$308.58–$443.06

51990 billing questions

How is 51990 different from 51992?

51990 describes laparoscopic urethral suspension, typically a suture-based colposuspension. Use 51992 when the surgeon performs a laparoscopic sling operation.

Are related preoperative and postoperative visits included?

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

Should modifier 50 be added for bilateral work?

No. Report the suspension as a single service; modifier 50 is inappropriate for this code.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What operative documentation supports 51990?

Document the laparoscopic access, the suspension technique, and the tissues secured to pelvic support structures. The note should make clear that a sling operation was not performed instead.

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 51990PPRRVU2026_Oct_nonQPP.csv, line 6,102 (RVU26D)

Open CMS sourceHow we calculate rates

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