No office rate
This code addresses repair of a urethral lesion. Code 57220 is identified as urethral revision and is not selected solely because the operation involves the urethra.
On this page
CMS RVU26D · Effective 2026-10-01
57230 Urethral repair Medicare reimbursement rates
Surgical repair of a female urethral lesion, commonly a diverticulum, reported when the procedure treats and closes the affected urethral tissue. Compare 57230 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 57230?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 57230 pays more and less
Urology surgery
About 57230: Female urethral lesion repair
Surgical repair of a female urethral lesion, commonly a diverticulum, reported when the procedure treats and closes the affected urethral tissue.
This procedure treats a lesion involving the female urethra, with a urethral diverticulum as a typical clinical example. A urologist or urogynecologist commonly performs the repair in an operating room, often through a vaginal approach, exposing the lesion and repairing the urethral tissue after treating it. The operative report should identify the lesion, its relationship to the urethra, and the repair performed.
Report the code for the urethral lesion repair itself, rather than for repair of an adjacent vaginal-wall prolapse or a urethral reconstruction performed for a different condition. This is major surgery with a 90-day global period; the day-before preoperative visit and related postoperative care during that period are included. 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. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 57230
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.14 · 55%
- Practice expense (office) RVU3.94 · 35%
- Malpractice RVU1.08 · 10%
53
Medicare services in 2024 · #5324 by national volume
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.
57230 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
Use 57230 for repair of a urethral lesion. Code 53430 describes female urethral reconstruction, a different operative purpose.
No office rate
Code 57240 addresses anterior vaginal wall repair. It is not the urethral lesion repair represented by 57230.
See how rates vary across the country
57230 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 57230 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $340.65 |
| Alaska* | Office Unavailable | Facility $467.65 |
| Arizona | Office Unavailable | Facility $363.48 |
| Arkansas | Office Unavailable | Facility $336.70 |
| Atlanta | Office Unavailable | Facility $382.73 |
| Austin | Office Unavailable | Facility $376.68 |
| Bakersfield | Office Unavailable | Facility $375.18 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $394.19 |
| Beaumont | Office Unavailable | Facility $358.35 |
| Brazoria | Office Unavailable | Facility $365.27 |
| Chicago | Office Unavailable | Facility $421.56 |
| Chico | Office Unavailable | Facility $372.14 |
| Colorado | Office Unavailable | Facility $375.74 |
| Connecticut | Office Unavailable | Facility $394.56 |
| Dallas | Office Unavailable | Facility $368.95 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $411.33 |
| Delaware | Office Unavailable | Facility $368.56 |
| Detroit | Office Unavailable | Facility $392.89 |
| East St. Louis | Office Unavailable | Facility $398.80 |
| El Centro | Office Unavailable | Facility $372.32 |
| Fort Lauderdale | Office Unavailable | Facility $403.61 |
| Fort Worth | Office Unavailable | Facility $368.10 |
| Fresno | Office Unavailable | Facility $372.14 |
| Galveston | Office Unavailable | Facility $367.27 |
| Hanford-Corcoran | Office Unavailable | Facility $372.14 |
| Hawaii, Guam | Office Unavailable | Facility $375.60 |
| Houston | Office Unavailable | Facility $387.04 |
| Idaho | Office Unavailable | Facility $343.22 |
| Indiana | Office Unavailable | Facility $344.61 |
| Iowa | Office Unavailable | Facility $339.82 |
| Kansas | Office Unavailable | Facility $342.23 |
| Kentucky | Office Unavailable | Facility $355.08 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $393.12 |
| Madera | Office Unavailable | Facility $372.14 |
| Manhattan | Office Unavailable | Facility $428.34 |
| Merced | Office Unavailable | Facility $372.14 |
| Metropolitan Boston | Office Unavailable | Facility $402.72 |
| Metropolitan Kansas City | Office Unavailable | Facility $363.90 |
| Metropolitan Philadelphia | Office Unavailable | Facility $388.80 |
| Metropolitan St. Louis | Office Unavailable | Facility $366.51 |
| Miami | Office Unavailable | Facility $433.31 |
| Minnesota | Office Unavailable | Facility $351.18 |
| Mississippi | Office Unavailable | Facility $345.05 |
| Modesto | Office Unavailable | Facility $372.14 |
| Montana** | Office Unavailable | Facility $372.68 |
| Napa | Office Unavailable | Facility $409.77 |
| Nebraska | Office Unavailable | Facility $340.18 |
| Nevada** | Office Unavailable | Facility $366.86 |
| New Hampshire | Office Unavailable | Facility $373.64 |
| New Mexico | Office Unavailable | Facility $369.08 |
| New Orleans | Office Unavailable | Facility $369.90 |
| North Carolina | Office Unavailable | Facility $350.91 |
| North Dakota** | Office Unavailable | Facility $351.33 |
| Northern Nj | Office Unavailable | Facility $409.18 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $441.67 |
| Ohio | Office Unavailable | Facility $361.59 |
| Oklahoma | Office Unavailable | Facility $350.63 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $388.85 |
| Portland | Office Unavailable | Facility $381.41 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $402.06 |
| Puerto Rico | Office Unavailable | Facility $373.66 |
| Queens | Office Unavailable | Facility $425.77 |
| Redding | Office Unavailable | Facility $372.14 |
| Rest Of California | Office Unavailable | Facility $372.14 |
| Rest Of Florida | Office Unavailable | Facility $385.11 |
| Rest Of Georgia | Office Unavailable | Facility $365.47 |
| Rest Of Illinois | Office Unavailable | Facility $381.61 |
| Rest Of Louisiana | Office Unavailable | Facility $356.11 |
| Rest Of Maine | Office Unavailable | Facility $348.59 |
| Rest Of Maryland | Office Unavailable | Facility $373.43 |
| Rest Of Massachusetts | Office Unavailable | Facility $375.69 |
| Rest Of Michigan | Office Unavailable | Facility $365.96 |
| Rest Of Missouri | Office Unavailable | Facility $353.66 |
| Rest Of New Jersey | Office Unavailable | Facility $396.56 |
| Rest Of New York | Office Unavailable | Facility $355.46 |
| Rest Of Oregon | Office Unavailable | Facility $361.51 |
| Rest Of Pennsylvania | Office Unavailable | Facility $359.98 |
| Rest Of Texas | Office Unavailable | Facility $362.54 |
| Rest Of Washington | Office Unavailable | Facility $373.77 |
| Rhode Island | Office Unavailable | Facility $377.10 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $383.78 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $384.85 |
| Salinas | Office Unavailable | Facility $383.30 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $388.18 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $426.68 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $425.45 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $436.74 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $431.73 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $377.79 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $388.62 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $383.60 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $392.17 |
| Seattle (King Cnty) | Office Unavailable | Facility $406.28 |
| South Carolina | Office Unavailable | Facility $357.34 |
| South Dakota** | Office Unavailable | Facility $348.80 |
| Southern Maine | Office Unavailable | Facility $358.26 |
| Stockton | Office Unavailable | Facility $372.14 |
| Suburban Chicago | Office Unavailable | Facility $405.59 |
| Tennessee | Office Unavailable | Facility $344.08 |
| Utah | Office Unavailable | Facility $361.18 |
| Vallejo | Office Unavailable | Facility $408.01 |
| Vermont | Office Unavailable | Facility $353.62 |
| Virgin Islands | Office Unavailable | Facility $373.66 |
| Virginia | Office Unavailable | Facility $359.91 |
| Visalia | Office Unavailable | Facility $372.14 |
| West Virginia | Office Unavailable | Facility $371.06 |
| Wisconsin | Office Unavailable | Facility $342.26 |
| Wyoming** | Office Unavailable | Facility $363.38 |
| Yuba City | Office Unavailable | Facility $372.14 |
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57230 billing questions
When is this code more appropriate than a urethral reconstruction code?
Use it when the operation repairs a urethral lesion, such as a diverticulum. A reconstructive urethroplasty code is for reconstruction of the urethra rather than repair of a lesion.
Is a urethral diverticulum a typical reason for reporting this code?
Yes. A diverticulum is a typical example of a lesion treated by this repair; the operative note should describe the lesion and the urethral repair.
Can modifier 50 be reported for a lesion on each side?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
How does the 90-day global period affect postoperative visits?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the global surgery payment.
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 when performed in the same session.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,45157200,,Repair of vagina,A,,4.31,4.01,NA,4.01,,0.80,9.12,9.12,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45257210,,Repair vagina/perineum,A,,5.57,4.05,NA,4.05,,1.01,10.63,10.63,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45357220,,Revision of urethra,A,,4.73,3.79,NA,3.79,,0.81,9.33,9.33,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45457230,,Repair of urethral lesion,A,,6.14,3.94,NA,3.94,,1.08,11.16,11.16,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45557240,,Anterior colporrhaphy,A,,9.83,4.88,NA,4.88,,1.61,16.32,16.32,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45657250,,Repair rectum & vagina,A,,9.83,4.85,NA,4.85,,1.65,16.33,16.33,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45757260,,Cmbn ant pst colprhy,A,,12.92,5.49,NA,5.49,,2.17,20.58,20.58,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00