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Billing code 53010: UrethrotomyMedicare rate & RVUs

External urethrotomy in a female patient is reported when a surgeon incises a urethral narrowing to restore the urethral lumen.

CMS RVU26DEffective Oct 1, 2026109 payment localities99 Medicare services in 2024

Medicare pays $281.24 for 53010 nationally in a facility.

Medicare rate · 53010

Urethrotomy

Swap in your local Medicare rate.

Work RVUs
4.34
Total RVUs
8.42
Global days
090

National rate · 2026

$281.24

Facility setting, before claim adjustments.

See every locality for 53010 → · 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 53010 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 53010 covers

A urologist performs an external urethrotomy to open a narrowed segment of the female urethra, typically for a urethral stricture causing impaired urine flow. The operation uses an external surgical approach rather than an endoscopic incision through a cystoscope. Medicare claims for this service are predominantly facility-based, consistent with the operative setting in which this procedure is performed.

Select this code for the external approach in a female patient, not for an incision confined to the urethral meatus or an endoscopic internal urethrotomy. The operative report should support the patient’s anatomy, the narrowed urethral segment, and the external incision performed. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care. When other procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery 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 53010 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

53010 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$258.32
Alaska*Unavailable$352.79
ArizonaUnavailable$274.86
ArkansasUnavailable$255.47
AtlantaUnavailable$287.37
AustinUnavailable$286.15
BakersfieldUnavailable$287.80
Baltimore/Surr. CntysUnavailable$296.63
BeaumontUnavailable$269.33
BrazoriaUnavailable$277.15

53010 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
53010 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 53010 rate is calculated

Each of 53010’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 · 53010

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.34Practice expense 3.51Malpractice 0.57

8.4200 adjusted RVUs×$33.4009 conversion factor=$281.24

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

Payment rules and modifiers for 53010

53010 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 53010

Urethrotomy

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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
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 · 53010

Urethrotomy

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

53010 without 51 · national facility

$281.24

Urethrotomy

53010-51 · Second procedure: 50%

$140.62

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

53010 compared with similar codes

Compare codes

53010 vs 53000 vs 53020 vs 52276 vs 53660: national Medicare rates

Swap in your local Medicare rate.

  • 53010
    Urethrotomy · 4.34 wRVU
    —
  • 53000
    Urethrotomy · 2.27 wRVU
    —
  • 53020
    Meatotomy · 1.73 wRVU
    —
  • 52276
    Urethral stricture treatment · 4.87 wRVU
    —
  • 53660
    Urethral dilation · 0.69 wRVU
    $78.83

How to choose

53000Urethrotomy
53000 is the external urethrotomy code for a male patient; 53010 is for a female patient.
53020Meatotomy
53020 describes meatotomy, an incision at the urethral meatus. Use 53010 for the external urethrotomy of a urethral narrowing in a female patient.
52276Urethral stricture treatment
52276 is an endoscopic internal urethrotomy performed through a cystoscope. 53010 represents the external approach in a female patient.
53660Urethral dilation
53660 is female urethral dilation; 53010 is an external surgical incision to open a urethral narrowing.

Codes related to 53010

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

Codes related to 53010
CodeHow it relatesNational office range
Same family
53000UrethrotomyExternal urethrotomy for a male patient; 53010 is the female counterpart.No office rate
Used instead
52276Urethral stricture treatmentEndoscopic internal urethrotomy for a urethral narrowing, rather than an external approach.No office rate
53660Urethral dilationFemale urethral dilation, an alternative approach to treating a urethral narrowing.$70.04–$103.59
53020MeatotomyMeatotomy for an incision at the urethral meatus, rather than an external urethrotomy.No office rate

53010 billing questions

How does this differ from code 53000?

Code 53010 is for external urethrotomy in a female patient; 53000 is the corresponding male service. The operative documentation should support the patient anatomy and external approach.

When should 53010 be used instead of 52276?

Use 53010 for an external urethrotomy in a female patient. Code 52276 describes an endoscopic internal urethrotomy performed through a cystoscope.

Is an incision of the urethral meatus reported with 53010?

No. An incision limited to the urethral meatus is a meatotomy, not the external urethrotomy represented by 53010.

Can modifier 50 be appended?

No. Modifier 50 is inappropriate for this code.

What postoperative care is included?

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

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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 53010PPRRVU2026_Oct_nonQPP.csv, line 6,172 (RVU26D)

Open CMS sourceHow we calculate rates

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