Billing code 53410: Urethral reconstructionMedicare rate & RVUs

Medicare pays $879.45 for 53410 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 53410 covers

A urologist uses this code for one-stage reconstruction of the male anterior urethra, commonly to restore the channel affected by a stricture or tissue defect. The operation may use local tissue or a graft to rebuild the narrowed or damaged segment. These procedures are generally performed in a surgical facility, with the operative report identifying the urethral site and reconstructive approach.

Select this code when the surgeon completes the anterior urethral reconstruction in one stage; a planned two-stage reconstruction follows the applicable stage-specific codes instead. Documentation should establish the anatomy treated, the reason for reconstruction, and the technique and extent of the repair. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment may be made; co-surgeons require 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 53410 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

53410 rates by state

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

How the 53410 rate is calculated

Each of 53410’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.

Payment rules and modifiers for 53410

53410 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

53410 compared with similar codes

How to choose

53415Urethroplasty

This code concerns one-stage reconstruction of the male anterior urethra. Code 53415 is for one-stage reconstruction involving the prostatic or membranous urethra.

53420Urethral reconstruction

Code 53420 represents the first stage of a planned two-stage male anterior urethral reconstruction; this code is for reconstruction completed in one stage.

53425Urethral reconstruction

Code 53425 represents the second stage of a planned two-stage male anterior urethral reconstruction, rather than a one-stage repair.

53430Urethral repair

Code 53430 is for female urethral reconstruction. This code is specific to the male anterior urethra.

Codes related to 53410

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

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

Open CMS sourceHow we calculate rates