$168.16
53200 describes biopsy of the urethra for tissue sampling. Use 53250 when the operative service removes Skene gland tissue.
On this page
CMS RVU26D · Effective 2026-10-01
53250 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$370.56
Base rate per service
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.
Urology surgery
About 53250: Excision of Skene glands
Removal of Skene glands is reported for surgical treatment of symptomatic periurethral gland disease when the gland tissue itself is excised.
This procedure removes Skene glands, the small paraurethral glands near the urethral opening, typically in a patient with symptomatic gland disease such as a cyst or recurrent inflammation. A urologist or urogynecologist generally performs the excision in an operating-room setting. The operative report should identify the gland tissue removed and describe the surgical work, rather than documenting only a biopsy or treatment of a urethral lesion.
Report 53250 when the documented service is excision of Skene glands; use the code that matches the actual structure and extent treated if the operation instead addresses another urethral condition. Medicare assigns 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. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 53250
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.36 · 58%
- Practice expense (office) RVU3.82 · 35%
- Malpractice RVU0.82 · 7%
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.
53250 compared with similar codes
Office rates for Modesto, from the same CMS release.
No office rate
53230 addresses excision of a urethral diverticulum. Choose 53250 when the operative target is Skene gland tissue instead.
$224.59
Both codes are described as urethral-gland removal codes in CMS data. Distinguish them by the full current CPT descriptors and the documented extent of the operation.
The same code, a different location
How does Modesto compare?
53250 across payment areas
Same release and payment basis · bars start at $0
Modesto · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 53250
Office
Unavailable
Facility
$370.56
No comparable office rate is available.
Merced
California · 53250
Office
Unavailable
Facility
$370.56
No comparable office rate is available.
Napa
California · 53250
Office
Unavailable
Facility
$407.89
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 53250
Office
Unavailable
Facility
$386.25
No comparable office rate is available.
Redding
California · 53250
Office
Unavailable
Facility
$370.56
No comparable office rate is available.
Rest Of California
California · 53250
Office
Unavailable
Facility
$370.56
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 53250
Office
Unavailable
Facility
$379.46
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 53250
Office
Unavailable
Facility
$383.15
No comparable office rate is available.
Salinas
California · 53250
Office
Unavailable
Facility
$381.57
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 53250
Office
Unavailable
Facility
$386.25
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 53250
Office
Unavailable
Facility
$425.09
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 53250
Office
Unavailable
Facility
$424.15
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 53250
Office
Unavailable
Facility
$434.46
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 53250
Office
Unavailable
Facility
$430.66
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 53250
Office
Unavailable
Facility
$376.05
No comparable office rate is available.
Santa Cruz-Watsonville
California · 53250
Office
Unavailable
Facility
$386.59
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 53250
Office
Unavailable
Facility
$381.83
No comparable office rate is available.
Santa Rosa-Petaluma
California · 53250
Office
Unavailable
Facility
$390.17
No comparable office rate is available.
Stockton
California · 53250
Office
Unavailable
Facility
$370.56
No comparable office rate is available.
Vallejo
California · 53250
Office
Unavailable
Facility
$406.55
No comparable office rate is available.
Visalia
California · 53250
Office
Unavailable
Facility
$370.56
No comparable office rate is available.
Yuba City
California · 53250
Office
Unavailable
Facility
$370.56
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 53250
Office
Unavailable
Facility
$404.69
No comparable office rate is available.
Miami
Florida · 53250
Office
Unavailable
Facility
$414.52
No comparable office rate is available.
Chicago
Illinois · 53250
Office
Unavailable
Facility
$405.00
No comparable office rate is available.
Manhattan
New York · 53250
Office
Unavailable
Facility
$417.73
No comparable office rate is available.
Alaska*
Alaska · 53250
Office
Unavailable
Facility
$469.62
No comparable office rate is available.
Alabama
Alabama · 53250
Office
Unavailable
Facility
$339.57
No comparable office rate is available.
Arkansas
Arkansas · 53250
Office
Unavailable
Facility
$336.14
No comparable office rate is available.
Arizona
Arizona · 53250
Office
Unavailable
Facility
$359.51
No comparable office rate is available.
Colorado
Colorado · 53250
Office
Unavailable
Facility
$372.13
No comparable office rate is available.
Connecticut
Connecticut · 53250
Office
Unavailable
Facility
$387.23
No comparable office rate is available.
Delaware
Delaware · 53250
Office
Unavailable
Facility
$364.17
No comparable office rate is available.
Fort Lauderdale
Florida · 53250
Office
Unavailable
Facility
$391.20
No comparable office rate is available.
Rest Of Florida
Florida · 53250
Office
Unavailable
Facility
$375.57
No comparable office rate is available.
Atlanta
Georgia · 53250
Office
Unavailable
Facility
$375.59
No comparable office rate is available.
Rest Of Georgia
Georgia · 53250
Office
Unavailable
Facility
$358.89
No comparable office rate is available.
Hawaii, Guam
Hawaii · 53250
Office
Unavailable
Facility
$373.36
No comparable office rate is available.
Iowa
Iowa · 53250
Office
Unavailable
Facility
$340.05
No comparable office rate is available.
Idaho
Idaho · 53250
Office
Unavailable
Facility
$342.77
No comparable office rate is available.
East St. Louis
Illinois · 53250
Office
Unavailable
Facility
$384.97
No comparable office rate is available.
Rest Of Illinois
Illinois · 53250
Office
Unavailable
Facility
$371.73
No comparable office rate is available.
Suburban Chicago
Illinois · 53250
Office
Unavailable
Facility
$393.49
No comparable office rate is available.
Indiana
Indiana · 53250
Office
Unavailable
Facility
$344.02
No comparable office rate is available.
Kansas
Kansas · 53250
Office
Unavailable
Facility
$341.58
No comparable office rate is available.
Kentucky
Kentucky · 53250
Office
Unavailable
Facility
$350.92
No comparable office rate is available.
New Orleans
Louisiana · 53250
Office
Unavailable
Facility
$363.61
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 53250
Office
Unavailable
Facility
$351.59
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 53250
Office
Unavailable
Facility
$397.86
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 53250
Office
Unavailable
Facility
$372.01
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 53250
Office
Unavailable
Facility
$386.61
No comparable office rate is available.
Rest Of Maryland
Maryland · 53250
Office
Unavailable
Facility
$368.82
No comparable office rate is available.
Rest Of Maine
Maine · 53250
Office
Unavailable
Facility
$346.85
No comparable office rate is available.
Southern Maine
Maine · 53250
Office
Unavailable
Facility
$356.16
No comparable office rate is available.
Detroit
Michigan · 53250
Office
Unavailable
Facility
$381.73
No comparable office rate is available.
Rest Of Michigan
Michigan · 53250
Office
Unavailable
Facility
$359.84
No comparable office rate is available.
Minnesota
Minnesota · 53250
Office
Unavailable
Facility
$351.83
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 53250
Office
Unavailable
Facility
$359.00
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 53250
Office
Unavailable
Facility
$361.34
No comparable office rate is available.
Rest Of Missouri
Missouri · 53250
Office
Unavailable
Facility
$349.09
No comparable office rate is available.
Mississippi
Mississippi · 53250
Office
Unavailable
Facility
$342.53
No comparable office rate is available.
Montana**
Montana · 53250
Office
Unavailable
Facility
$367.36
No comparable office rate is available.
North Carolina
North Carolina · 53250
Office
Unavailable
Facility
$348.97
No comparable office rate is available.
North Dakota**
North Dakota · 53250
Office
Unavailable
Facility
$351.14
No comparable office rate is available.
Nebraska
Nebraska · 53250
Office
Unavailable
Facility
$340.55
No comparable office rate is available.
New Hampshire
New Hampshire · 53250
Office
Unavailable
Facility
$369.22
No comparable office rate is available.
Northern Nj
New Jersey · 53250
Office
Unavailable
Facility
$403.07
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 53250
Office
Unavailable
Facility
$390.30
No comparable office rate is available.
New Mexico
New Mexico · 53250
Office
Unavailable
Facility
$362.32
No comparable office rate is available.
Nevada**
Nevada · 53250
Office
Unavailable
Facility
$362.96
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 53250
Office
Unavailable
Facility
$428.59
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 53250
Office
Unavailable
Facility
$394.84
No comparable office rate is available.
Queens
New York · 53250
Office
Unavailable
Facility
$416.33
No comparable office rate is available.
Rest Of New York
New York · 53250
Office
Unavailable
Facility
$352.90
No comparable office rate is available.
Ohio
Ohio · 53250
Office
Unavailable
Facility
$356.53
No comparable office rate is available.
Oklahoma
Oklahoma · 53250
Office
Unavailable
Facility
$347.65
No comparable office rate is available.
Portland
Oregon · 53250
Office
Unavailable
Facility
$377.96
No comparable office rate is available.
Rest Of Oregon
Oregon · 53250
Office
Unavailable
Facility
$358.77
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 53250
Office
Unavailable
Facility
$381.75
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 53250
Office
Unavailable
Facility
$355.44
No comparable office rate is available.
Puerto Rico
Puerto Rico · 53250
Office
Unavailable
Facility
$368.40
No comparable office rate is available.
Rhode Island
Rhode Island · 53250
Office
Unavailable
Facility
$372.70
No comparable office rate is available.
South Carolina
South Carolina · 53250
Office
Unavailable
Facility
$353.60
No comparable office rate is available.
South Dakota**
South Dakota · 53250
Office
Unavailable
Facility
$349.22
No comparable office rate is available.
Tennessee
Tennessee · 53250
Office
Unavailable
Facility
$343.12
No comparable office rate is available.
Austin
Texas · 53250
Office
Unavailable
Facility
$372.11
No comparable office rate is available.
Beaumont
Texas · 53250
Office
Unavailable
Facility
$353.98
No comparable office rate is available.
Brazoria
Texas · 53250
Office
Unavailable
Facility
$361.94
No comparable office rate is available.
Dallas
Texas · 53250
Office
Unavailable
Facility
$364.92
No comparable office rate is available.
Fort Worth
Texas · 53250
Office
Unavailable
Facility
$364.00
No comparable office rate is available.
Galveston
Texas · 53250
Office
Unavailable
Facility
$363.51
No comparable office rate is available.
Houston
Texas · 53250
Office
Unavailable
Facility
$378.51
No comparable office rate is available.
Rest Of Texas
Texas · 53250
Office
Unavailable
Facility
$358.25
No comparable office rate is available.
Utah
Utah · 53250
Office
Unavailable
Facility
$356.96
No comparable office rate is available.
Virginia
Virginia · 53250
Office
Unavailable
Facility
$357.19
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 53250
Office
Unavailable
Facility
$368.40
No comparable office rate is available.
Vermont
Vermont · 53250
Office
Unavailable
Facility
$352.60
No comparable office rate is available.
Rest Of Washington
Washington · 53250
Office
Unavailable
Facility
$370.39
No comparable office rate is available.
Seattle (King Cnty)
Washington · 53250
Office
Unavailable
Facility
$401.98
No comparable office rate is available.
Wisconsin
Wisconsin · 53250
Office
Unavailable
Facility
$343.10
No comparable office rate is available.
West Virginia
West Virginia · 53250
Office
Unavailable
Facility
$362.50
No comparable office rate is available.
Wyoming**
Wyoming · 53250
Office
Unavailable
Facility
$360.29
No comparable office rate is available.
See how rates vary across the country
53250 · 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 |
Where does this rate apply?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 53250 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$407.62
$370.56 × 110% = $407.62
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 53250 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
6,186
- Code
- 53250
- Physician work
- 6.36
- Practice expense
- 3.82
- Malpractice
- 0.82
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.36 | × 1.017 | 6.4681 |
| Practice expense | 3.82 | × 1.096 | 4.1867 |
| Malpractice | 0.82 | × 0.536 | 0.4395 |
| Total RVUs | 11.0944 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$370.56
Open 53250 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.36 | 1.017 |
| Practice expense | 3.82 | 1.096 |
| Malpractice | 0.82 | 0.536 |
(6.36 × 1.017 + 3.82 × 1.096 + 0.82 × 0.536) × $33.4009 = $370.56
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
53250 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $370.56 | RVU26D |
| 2026-07-01 | Not available in this setting | $370.56 | RVU26C |
| 2026-04-01 | Not available in this setting | $370.56 | RVU26B |
| 2026-01-01 | Not available in this setting | $370.56 | RVU26A |
| 2025-10-01 | Not available in this setting | $394.86 | RVU25D |
| 2025-07-01 | Not available in this setting | $394.86 | RVU25C |
| 2025-04-01 | Not available in this setting | $394.86 | RVU25B |
| 2025-01-01 | Not available in this setting | $394.86 | RVU25A |
53250 billing questions
When should 53250 be chosen over a urethral biopsy?
Use 53250 when Skene gland tissue is surgically excised. A urethral biopsy code describes sampling tissue for diagnosis, not removal of the gland.
Does the 90-day global period include routine postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Should modifier 50 be appended for glands on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
How is 53250 paid when another procedure is done in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
What documentation supports reporting 53250?
Document the Skene gland tissue removed and the operative work performed. Documentation of a urethral lesion or diverticulum alone does not establish gland excision.
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.
6,18353230,,Removal of urethra lesion,A,,10.18,4.94,NA,4.94,,1.47,16.59,16.59,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18453235,,Removal of urethra lesion,A,,10.72,5.21,NA,5.21,,1.36,17.29,17.29,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18553240,,Surgery for urethra pouch,A,,6.90,3.95,NA,3.95,,0.89,11.74,11.74,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18653250,,Removal of urethra gland,A,,6.36,3.82,NA,3.82,,0.82,11.00,11.00,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18753260,,Treatment of urethra lesion,A,,2.95,3.02,,1.58,,0.43,6.40,4.96,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18853265,,Treatment of urethra lesion,A,,3.09,3.38,,1.55,,0.46,6.93,5.10,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18953270,,Removal of urethra gland,A,,3.06,3.10,,1.61,,0.40,6.56,5.07,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623
1901112,CA,61,REDDING,1.017,1.096,0.536