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Billing code 53448: Sphincter replacementMedicare rate & RVUs

Reports removal and replacement of urinary sphincter components, typically during operative management of a malfunctioning or otherwise unsuitable artificial urinary sphincter.

CMS RVU26DEffective Oct 1, 2026109 payment localities55 Medicare services in 2024

Medicare pays $1,142.98 for 53448 nationally in a facility.

Medicare rate · 53448

Sphincter replacement

Swap in your local Medicare rate.

Work RVUs
22.85
Total RVUs
34.22
Global days
090

National rate · 2026

$1,142.98

Facility setting, before claim adjustments.

See every locality for 53448 → · 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 53448 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 53448 covers

This operation involves removing and replacing urinary sphincter components, generally as revision of an implanted artificial urinary sphincter system. Urologists commonly perform it in a hospital or ambulatory surgery center for a patient whose implanted device requires operative replacement. The operative report should identify the components removed and implanted and describe the reason for the procedure, such as device malfunction or a change in the patient’s clinical condition.

Choose this code when the documented work matches its component removal-and-replacement service; distinguish it from removal alone, initial insertion, and repair without component replacement. The service has a 90-day global period, which includes 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% reduction. 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 53448 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

53448 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,065.16
Alaska*Unavailable$1,498.79
ArizonaUnavailable$1,120.11
ArkansasUnavailable$1,055.65
AtlantaUnavailable$1,169.51
AustinUnavailable$1,149.64
BakersfieldUnavailable$1,146.11
Baltimore/Surr. CntysUnavailable$1,199.02
BeaumontUnavailable$1,110.67
BrazoriaUnavailable$1,124.95

53448 rates by state

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

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Explore a state

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
53448 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 53448 rate is calculated

Each of 53448’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 · 53448

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 22.85Practice expense 8.43Malpractice 2.94

34.2200 adjusted RVUs×$33.4009 conversion factor=$1,142.98

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

Payment rules and modifiers for 53448

53448 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 53448

Sphincter replacement

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 · 53448

Sphincter replacement

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

53448 without 51 · national facility

$1,142.98

Sphincter replacement

53448-51 · Second procedure: 50%

$571.49

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

53448 compared with similar codes

Compare codes

53448 vs 53446 vs 53445 vs 53447 vs 53449: national Medicare rates

Swap in your local Medicare rate.

  • 53448
    Sphincter replacement · 22.85 wRVU
    —
  • 53446
    Sphincter removal · 10.74 wRVU
    —
  • 53445
    Artificial sphincter · 12.68 wRVU
    —
  • 53447
    Sphincter replacement · 13.92 wRVU
    —
  • 53449
    Sphincter repair · 10.3 wRVU
    —

How to choose

53446Sphincter removal
Use 53446 when the urinary sphincter is removed without replacement. Use 53448 when the documented service includes component replacement.
53445Artificial sphincter
Code 53445 is for initial insertion of an inflatable urinary sphincter system; 53448 concerns removal and replacement of components in an existing system.
53447Sphincter replacement
Both codes address urinary sphincter removal and replacement. Determine the appropriate code from the exact component work and procedure documented.
53449Sphincter repair
Code 53449 describes sphincter repair. It is not the component replacement service reported with 53448.

Codes related to 53448

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

Codes related to 53448
CodeHow it relatesNational office range
Used instead
53445Artificial sphincterInitial insertion of an inflatable urinary sphincter system rather than removal and replacement.No office rate
53446Sphincter removalRemoval of a urinary sphincter without replacement.No office rate
53449Sphincter repairRepair of a urinary sphincter rather than component removal and replacement.No office rate
Same family
53447Sphincter replacementNearby urinary sphincter removal-and-replacement code; distinguish by the documented service.No office rate
53444Tandem cuffRelated urinary sphincter procedure involving placement of a tandem cuff.No office rate

53448 billing questions

How does this differ from 53446?

Code 53446 is for removal of the urinary sphincter without replacement. Use 53448 when the operative report supports removal and replacement of the components described by this service.

How does this differ from 53445?

Code 53445 describes initial insertion of an inflatable urinary sphincter system. This code describes removal and replacement of components of an existing system.

How should this be distinguished from 53447?

Both codes concern urinary sphincter removal and replacement. Select based on the exact service and component work documented in the operative report, rather than treating the codes as interchangeable.

Are related postoperative visits included?

Yes. 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.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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 53448PPRRVU2026_Oct_nonQPP.csv, line 6,205 (RVU26D)

Open CMS sourceHow we calculate rates

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