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Billing code 53430: Urethral repairMedicare rate & RVUs

Reconstructive surgery on the female urethra, reported for a repair that rebuilds the urethral channel rather than a limited revision.

CMS RVU26DEffective Oct 1, 2026109 payment localities213 Medicare services in 2024

Medicare pays $873.10 for 53430 nationally in a facility.

Medicare rate · 53430

Urethral repair

Swap in your local Medicare rate.

Work RVUs
16.99
Total RVUs
26.14
Global days
090

National rate · 2026

$873.10

Facility setting, before claim adjustments.

See every locality for 53430 → · 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 53430 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 53430 covers

This operation rebuilds the female urethra to restore a usable channel, such as when a stricture or structural defect requires reconstructive repair. A urologist or female pelvic medicine and reconstructive surgeon typically performs it in an operating room, using an approach suited to the location and extent of the urethral problem. The operative report should identify the defect and describe the reconstruction performed.

Report this code for female urethral reconstruction; use a neighboring code when the operative work instead includes bladder neck reconstruction or addresses a different urethral anatomy or procedure. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed 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 for this single urethral reconstruction. An assistant at surgery may be paid; 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 53430 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

53430 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$809.71
Alaska*Unavailable$1,134.82
ArizonaUnavailable$854.42
ArkansasUnavailable$801.97
AtlantaUnavailable$894.77
AustinUnavailable$877.94
BakersfieldUnavailable$873.53
Baltimore/Surr. CntysUnavailable$917.86
BeaumontUnavailable$847.14
BrazoriaUnavailable$857.69

53430 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
53430 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 53430 rate is calculated

Each of 53430’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 · 53430

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.99Practice expense 6.71Malpractice 2.44

26.1400 adjusted RVUs×$33.4009 conversion factor=$873.10

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

Payment rules and modifiers for 53430

53430 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 53430

Urethral 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 · 53430

Urethral 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

53430 without 51 · national facility

$873.10

Urethral repair

53430-51 · Second procedure: 50%

$436.55

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

53430 compared with similar codes

Compare codes

53430 vs 53431 vs 53410 vs 53415 vs 53450: national Medicare rates

Swap in your local Medicare rate.

  • 53430
    Urethral repair · 16.99 wRVU
    —
  • 53431
    Urethral reconstruction · 20.65 wRVU
    —
  • 53410
    Urethral reconstruction · 17.24 wRVU
    —
  • 53415
    Urethroplasty · 20.18 wRVU
    —
  • 53450
    Urethral revision · 6.6 wRVU
    —

How to choose

53431Urethral reconstruction
Choose 53431 when the female urethral reconstruction also includes bladder neck reconstruction. Use 53430 for reconstruction of the female urethra without that additional bladder neck work.
53410Urethral reconstruction
53410 describes one-stage reconstruction of the male anterior urethra; 53430 is for female urethral reconstruction.
53415Urethroplasty
53415 addresses one-stage reconstruction of the male prostatic or membranous urethra, rather than reconstruction of the female urethra.
53450Urethral revision
53450 is for revision of the urethra. Choose 53430 when the operative work is reconstructive rebuilding of the female urethra rather than a revision procedure.

Codes related to 53430

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

Codes related to 53430
CodeHow it relatesNational office range
Same family
53431Urethral reconstructionFemale urethral reconstruction that also includes bladder neck reconstruction.No office rate
53410Urethral reconstructionOne-stage reconstruction of the male anterior urethra.No office rate
53415UrethroplastyOne-stage reconstruction involving the male prostatic or membranous urethra.No office rate
53420Urethral reconstructionFirst stage of a two-stage reconstruction of the male anterior urethra.No office rate

53430 billing questions

When is 53431 used instead?

Use 53431 when the operation reconstructs the female urethra and also reconstructs the bladder neck. The operative report should support that additional bladder neck work.

How does 53430 differ from male urethroplasty codes?

53430 is for reconstruction of the female urethra. Codes such as 53410 and 53415 describe reconstruction involving male urethral anatomy.

Can modifier 50 be appended?

No. Modifier 50 is inappropriate for this reconstruction of the female urethra.

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.

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 53430PPRRVU2026_Oct_nonQPP.csv, line 6,197 (RVU26D)

Open CMS sourceHow we calculate rates

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