Billing code 53621: Urethral dilationMedicare rate & RVUs
Reports a subsequent dilation of a female urethral stricture using sounds or dilators, when the service follows the initial dilation.
Medicare pays $167.00 for 53621 nationally in the office and $63.80 in a hospital or facility. Local office rates run $147.72–$221.04.
Medicare rate · 53621
Urethral dilation
Swap in your local Medicare rate.
- Work RVUs
- 1.32
- Total RVUs
- 5.00
- Global days
- 000
National rate · 2026
$167.00
Office setting, before claim adjustments.
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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
What 53621 covers
This code applies to a subsequent urethral stricture dilation in a female patient using sounds or dilators to widen the narrowed urethral passage. A urologist typically performs the procedure in an office or outpatient facility. It is distinct from dilation of a female urethra when a urethral stricture is not the condition being treated.
Select the subsequent-service code rather than the initial-service code based on where the dilation falls in the treatment sequence, not the stricture’s severity. Document the stricture, the patient’s anatomy, the dilation performed, and why this was a subsequent service. The 0-day global period includes same-day preoperative and 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; assistant-at-surgery payment is restricted, and co-surgery and team-surgery payment 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 53621 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$147.72 to $221.04
109 of 109 payment localities
53621 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.
$147.72
$198.70
Color shows the midpoint of each state’s locality range.
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| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $194.12 | 1 |
| AL | $149.89 | 1 |
| AR | $147.72 | 1 |
| AZ | $162.55 | 1 |
| CA | $176.37–$221.04 | 29 |
| CO | $173.79 | 1 |
| CT | $178.11 | 1 |
| DC | $190.90 | 1 |
| DE | $165.24 | 1 |
| FL | $164.70–$180.49 | 3 |
| GA | $155.43–$170.15 | 2 |
| GU | $180.68 | 1 |
| HI | $180.68 | 1 |
| IA | $153.62 | 1 |
| ID | $154.63 | 1 |
| IL | $160.00–$175.25 | 4 |
| IN | $155.53 | 1 |
| KS | $152.93 | 1 |
| KY | $153.51 | 1 |
| LA | $153.28–$160.86 | 2 |
| MA | $172.77–$190.93 | 2 |
| MD | $168.39–$190.90 | 3 |
| ME | $155.48–$163.85 | 2 |
| MI | $157.54–$166.80 | 2 |
| MN | $166.41 | 1 |
| MO | $150.68–$161.39 | 3 |
| MS | $149.23 | 1 |
| MT | $166.99 | 1 |
| NC | $157.10 | 1 |
| ND | $163.63 | 1 |
| NE | $154.45 | 1 |
| NH | $171.10 | 1 |
| NJ | $180.10–$188.93 | 2 |
| NM | $158.42 | 1 |
| NV | $166.17 | 1 |
| NY | $159.46–$196.85 | 5 |
| OH | $156.85 | 1 |
| OK | $153.19 | 1 |
| OR | $164.85–$179.27 | 2 |
| PA | $157.08–$173.70 | 2 |
| PR | $168.21 | 1 |
| RI | $171.10 | 1 |
| SC | $157.24 | 1 |
| SD | $163.23 | 1 |
| TN | $153.71 | 1 |
| TX | $156.05–$173.25 | 8 |
| UT | $159.39 | 1 |
| VA | $163.34–$190.90 | 2 |
| VI | $168.21 | 1 |
| VT | $163.03 | 1 |
| WA | $172.43–$194.78 | 2 |
| WI | $158.15 | 1 |
| WV | $154.09 | 1 |
| WY | $165.53 | 1 |
How the 53621 rate is calculated
Each of 53621’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 · 53621
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.32Practice expense 3.51Malpractice 0.17
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 53621
The CMS indicators that decide how 53621 is paid alongside other services.
CMS payment indicators · 53621
Urethral dilation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
53621 without 51 · national office
$167.00
Urethral dilation
53621-51 · Second procedure: 50%
$83.50
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%).
53621 compared with similar codes
Compare codes
53621 vs 53620 vs 53601 vs 53661: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 53620Urethral dilation
- Both apply to female urethral stricture dilation. Choose 53620 for the initial dilation and 53621 for a subsequent dilation.
- 53601Urethral dilation
- This is the subsequent-service code for male urethral stricture dilation; 53621 is for a female patient.
- 53661Urethral dilation
- This belongs to the separate series for female urethral dilation. Use 53621 when treating a female urethral stricture with a subsequent dilation.
53621 billing questions
How does this differ from 53620?
53620 is the initial dilation code for a female urethral stricture. Use 53621 for a subsequent dilation in the treatment sequence.
Can 53621 be reported for a male patient?
No. This code is for subsequent dilation of a female urethral stricture; male stricture dilation is coded in the male-specific code series.
How does this differ from 53661?
53621 concerns a urethral stricture and a subsequent dilation. Code 53661 is in the separate series for female urethral dilation.
Should modifier 50 be appended?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. Other procedures performed in the same session may be subject to the standard multiple-procedure reduction.
What documentation supports reporting 53621?
Document the female patient’s urethral stricture, the dilation performed with sounds or dilators, and why the service is subsequent rather than initial.
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
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