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Billing code 53500: UrethrolysisMedicare rate & RVUs

Transvaginal urethrolysis frees the female urethra from scar tissue or tethering causing obstruction, often after prior anti-incontinence surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities368 Medicare services in 2024

Medicare pays $672.69 for 53500 nationally in a facility.

Medicare rate · 53500

Urethrolysis

Swap in your local Medicare rate.

Work RVUs
12.68
Total RVUs
20.14
Global days
090

National rate · 2026

$672.69

Facility setting, before claim adjustments.

See every locality for 53500 → · 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 53500 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 53500 covers

A urologist or urogynecologist uses a vaginal approach to release scar tissue or adhesions restricting the female urethra. A typical situation is persistent difficulty emptying the bladder from urethral tethering after prior anti-incontinence surgery. Endoscopic control may be used during the operation, but the code describes the transvaginal release whether or not it is used. This is an operative service, generally performed in a surgical setting, rather than an office treatment for urinary symptoms.

Report the code when the operative work frees the urethra from obstructing periurethral scar or fixation; document the cause of obstruction, relevant prior surgery, operative findings, and the release performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple 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 for this anatomy. Assistant-at-surgery payment may be made; 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 53500 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

53500 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$621.63
Alaska*Unavailable$867.52
ArizonaUnavailable$657.69
ArkansasUnavailable$615.39
AtlantaUnavailable$689.88
AustinUnavailable$676.91
BakersfieldUnavailable$673.27
Baltimore/Surr. CntysUnavailable$708.23
BeaumontUnavailable$651.49
BrazoriaUnavailable$660.24

53500 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
53500 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 53500 rate is calculated

Each of 53500’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 · 53500

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 12.68Practice expense 5.53Malpractice 1.93

20.1400 adjusted RVUs×$33.4009 conversion factor=$672.69

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

Payment rules and modifiers for 53500

53500 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 53500

Urethrolysis

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)0.12/0.74/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 53500

Urethrolysis

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

53500 without 51 · national facility

$672.69

Urethrolysis

53500-51 · Second procedure: 50%

$336.35

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

53500 compared with similar codes

Compare codes

53500 vs 57287 vs 53410 vs 53502: national Medicare rates

Swap in your local Medicare rate.

  • 53500
    Urethrolysis · 12.68 wRVU
    —
  • 57287
    Sling revision · 10.87 wRVU
    —
  • 53410
    Urethral reconstruction · 17.24 wRVU
    —
  • 53502
    Urethral repair · 8.05 wRVU
    —

How to choose

57287Sling revision
Use 57287 for removal or revision of a sling when that is the operative treatment. Urethrolysis frees the urethra from scar or tethering; both may be needed in selected cases.
53410Urethral reconstruction
This code describes one-stage reconstruction of the female urethra. Choose 53500 when the work is release of periurethral scar, not reconstruction of the urethral channel.
53502Urethral repair
This code is for urethral injury repair. Choose 53500 for transvaginal urethral release when the operative problem is scar-related restriction rather than an injury.

Codes related to 53500

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

Codes related to 53500
CodeHow it relatesNational office range
Often billed with
57287Sling revisionMay accompany urethrolysis when treatment also requires revision or removal of a causative sling.No office rate
Used instead
53410Urethral reconstructionFemale urethral reconstruction is considered for a defect requiring repair, rather than external scar release.No office rate
Same family
53502Urethral repairUrethral injury repair is a distinct operation from transvaginal release of obstructing scar.No office rate

53500 billing questions

When should 53500 be chosen instead of a urethral repair code?

Use 53500 for transvaginal release of scar or tethering that restricts the urethra. A urethral repair code describes repair of an injury or defect, not release of external fixation.

Can 53500 be reported when endoscopic control is used?

Yes. Endoscopic control may be used as part of the transvaginal urethrolysis; its use does not change the selection of 53500.

Should modifier 50 be appended for bilateral work?

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

What supports reporting 53500?

Document the urethral obstruction or tethering, the relevant scar or prior operative history, and the transvaginal release performed. The note should make clear that the work freed the urethra rather than repaired a urethral injury.

How does the 90-day global affect postoperative visits?

The day-before preoperative visit and related postoperative care during the 90-day period are included in the global surgical service.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. 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 53500PPRRVU2026_Oct_nonQPP.csv, line 6,213 (RVU26D)

Open CMS sourceHow we calculate rates

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