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Billing code 53520: Urethral repairMedicare rate & RVUs

Repair a documented urethral defect by operative closure or reconstruction, distinguishing this service from repair of a urethral injury.

CMS RVU26DEffective Oct 1, 2026109 payment localities37 Medicare services in 2024

Medicare pays $512.37 for 53520 nationally in a facility.

Medicare rate · 53520

Urethral repair

Swap in your local Medicare rate.

Work RVUs
9.24
Total RVUs
15.34
Global days
090

National rate · 2026

$512.37

Facility setting, before claim adjustments.

See every locality for 53520 → · 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 53520 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 53520 covers

A urologist or other qualified surgeon uses this code for operative repair of a defect in the urethra. The procedure addresses the urethral defect itself, with the operative approach and repair tailored to its location and extent. It is generally performed in an operating room rather than as an office service.

Report the code when the operative note identifies the urethral defect and describes the repair performed; distinguish a defect repair from a repair coded specifically as treatment of a urethral injury. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. 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. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, 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 53520 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

53520 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$474.52
Alaska*Unavailable$659.32
ArizonaUnavailable$501.52
ArkansasUnavailable$469.85
AtlantaUnavailable$523.97
AustinUnavailable$517.91
BakersfieldUnavailable$518.27
Baltimore/Surr. CntysUnavailable$538.75
BeaumontUnavailable$494.79
BrazoriaUnavailable$504.55

53520 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
53520 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 53520 rate is calculated

Each of 53520’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 · 53520

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.24Practice expense 4.90Malpractice 1.20

15.3400 adjusted RVUs×$33.4009 conversion factor=$512.37

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

Payment rules and modifiers for 53520

53520 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 53520

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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
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 · 53520

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

53520 without 51 · national facility

$512.37

Urethral repair

53520-51 · Second procedure: 50%

$256.19

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

53520 compared with similar codes

Compare codes

53520 vs 53502 vs 53505 vs 53510 vs 53515: national Medicare rates

Swap in your local Medicare rate.

  • 53520
    Urethral repair · 9.24 wRVU
    —
  • 53502
    Urethral repair · 8.05 wRVU
    —
  • 53505
    Urethral repair · 8.05 wRVU
    —
  • 53510
    Urethral injury repair · 10.69 wRVU
    —
  • 53515
    Urethral repair · 13.86 wRVU
    —

How to choose

53502Urethral repair
This code addresses a urethral defect. Code 53502 is for urethral injury repair; base selection on the operative diagnosis and the full descriptor.
53505Urethral repair
Use 53520 for repair of a documented urethral defect, not an injury repair described by 53505.
53510Urethral injury repair
Code 53510 describes urethral injury repair. This code is for repair of a urethral defect rather than an injury.
53515Urethral repair
Choose 53515 when the operative service meets its injury-repair description; use this code for a urethral defect repair.

Codes related to 53520

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

Codes related to 53520
CodeHow it relatesNational office range
Used instead
53502Urethral repairFor urethral injury repair rather than repair of a documented urethral defect.No office rate
53505Urethral repairA urethral injury repair code; distinguish the injury indication from a defect repair.No office rate
53510Urethral injury repairUsed for a urethral injury repair in the circumstances specified by its full descriptor.No office rate
53515Urethral repairAnother injury-specific urethral repair code; use when the documented service matches its descriptor.No office rate

53520 billing questions

How is this code distinguished from the urethral injury repair codes?

Use this code for repair of a documented urethral defect. Codes 53502, 53505, 53510, and 53515 address urethral injury repair; select among them using the specific injury circumstances and the full code descriptions.

What documentation supports reporting this service?

The operative report should identify the urethral defect, describe its location and extent, and explain the repair performed. It should make clear whether the service treats a defect or a urethral injury.

Can modifier 50 be used for bilateral repair?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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 53520PPRRVU2026_Oct_nonQPP.csv, line 6,218 (RVU26D)

Open CMS sourceHow we calculate rates

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