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Billing code 53020: MeatotomyMedicare rate & RVUs

A urologist incises a narrowed urethral opening to relieve meatal stenosis in a non-infant patient.

CMS RVU26DEffective Oct 1, 2026109 payment localities166 Medicare services in 2024

Medicare pays $86.17 for 53020 nationally in a facility.

Medicare rate · 53020

Meatotomy

Work RVUs
1.73
Total RVUs
2.58
Global days
000

National rate · 2026

$86.17

Facility setting, before claim adjustments.

See every locality for 53020 →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 53020 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 53020 covers

This code represents a meatotomy: an incision at the urethral meatus to open a narrowed external opening, typically for meatal stenosis that obstructs or disrupts the urinary stream. A urologist commonly performs the procedure in an office or outpatient surgical setting. The code is for a non-infant patient; the infant-specific sibling is 53025.

Select the code when the treated narrowing is at the meatus, rather than a stricture farther along the urethra requiring urethrotomy. The record should identify the meatal narrowing and document the incision performed. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one 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. Assistant-at-surgery services are not paid, and 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 53020 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

53020 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$80.46
Alaska*Unavailable$113.31
ArizonaUnavailable$84.50
ArkansasUnavailable$79.76
AtlantaUnavailable$88.10
AustinUnavailable$86.73
BakersfieldUnavailable$86.58
Baltimore/Surr. CntysUnavailable$90.32
BeaumontUnavailable$83.75
BrazoriaUnavailable$84.90

53020 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
53020 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 53020 rate is calculated

Each of 53020’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 · 53020

RVUs × geographic indexes × conversion factor

Work1.73

1.73 RVUs× 1.000 GPCI

Practice expense0.64

0.64 RVUs× 1.000 GPCI

Malpractice0.21

0.21 RVUs× 1.000 GPCI

Adjusted RVUs

2.5800

Conversion factor

$33.4009

Medicare rate

$86.17

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

Payment rules and modifiers for 53020

The CMS indicators that decide how 53020 is paid alongside other services.

CMS payment indicators · 53020

Meatotomy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

53020 without 51 · national facility

$86.17

Meatotomy

53020-51 · Second procedure: 50%

$43.09

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

53020 compared with similar codes

Compare codes · National

4 codes, side by side

  • 53020

    Meatotomy1.73 wRVU

    Not priced

  • 53025

    Urethrotomy1.1 wRVU

    Not priced

  • 53000

    Urethrotomy2.27 wRVU

    Not priced

  • 53010

    Urethrotomy4.34 wRVU

    Not priced

How to choose

53025Urethrotomy
Both codes describe meatotomy. Choose 53025 for an infant and 53020 for a non-infant patient.
53000Urethrotomy
53020 incises the urethral meatus; 53000 describes an external urethrotomy for narrowing farther along the urethra.
53010Urethrotomy
53020 treats meatal narrowing, while 53010 describes internal urethrotomy for a stricture within the urethra.

Codes related to 53020

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

Codes related to 53020
CodeHow it relatesNational office range
Same family
53025UrethrotomyInfant-specific meatotomy code; 53020 is for a non-infant patient.No office rate
Used instead
53000UrethrotomyExternal urethrotomy addresses urethral narrowing beyond the meatus.No office rate
53010UrethrotomyInternal urethrotomy addresses urethral narrowing beyond the meatus.No office rate

53020 billing questions

When should 53020 be chosen over 53025?

Use 53020 for a non-infant patient undergoing meatotomy. Code 53025 is the infant-specific sibling.

How does this differ from urethrotomy codes 53000 and 53010?

53020 treats narrowing at the urethral meatus. Codes 53000 and 53010 describe external and internal urethrotomy, respectively, for urethral narrowing beyond the meatal opening.

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are multiple procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple-procedure reduction.

Can an assistant or co-surgeon be billed?

Assistant-at-surgery services are not paid for this code. Co-surgeon and team-surgery billing are not permitted.

What same-day care is included?

The 0-day global period includes same-day preoperative and postoperative care.

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 53020PPRRVU2026_Oct_nonQPP.csv, line 6,173 (RVU26D)

Open CMS sourceHow we calculate rates

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