No office rate
Choose 51990 for laparoscopic urethral suspension, commonly a Burch-type colposuspension; choose 51992 for a laparoscopic sling operation.
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CMS RVU26D · Effective 2026-10-01
51990 Urethral suspension Medicare reimbursement rates in Alabama
Laparoscopic urethral suspension treats stress urinary incontinence by elevating periurethral support tissues and is reported when that operation is performed. Compare 51990 office and facility rates across CMS payment localities in Alabama.
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 51990 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$623.90
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
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.
Urogynecology surgery
About 51990: Laparoscopic urethral suspension
Laparoscopic urethral suspension treats stress urinary incontinence by elevating periurethral support tissues and is reported when that operation is performed.
51990 describes laparoscopic suspension of urethral support tissues to treat stress urinary incontinence, commonly using a Burch-type colposuspension. Through abdominal ports, the surgeon places sutures in tissue beside the urethra and secures it to pelvic support structures, elevating support at the bladder neck. Urologists and urogynecologists typically perform the procedure in an operating room under anesthesia for patients with leakage during coughing, exertion, or sneezing.
Select this code for laparoscopic urethral suspension, not a laparoscopic graft or synthetic sling operation (51992). The operative report should establish the laparoscopic approach, suspension technique, and tissues fixed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. When other procedures occur in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard 50% multiple-procedure reduction. Do not use modifier 50; this is a single suspension service, not a paired-side procedure. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 51990
- 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 RVU13.03 · 65%
- Practice expense (office) RVU5.35 · 27%
- Malpractice RVU1.71 · 9%
2.4K
Medicare services in 2024 · #2339 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.
51990 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
Both address stress urinary incontinence with suspension or sling support, but 57288 describes a sling operation performed by a nonlaparoscopic approach.
$312.80
51715 describes urethral bulking by injection, not laparoscopic elevation and fixation of urethral support tissues.
Compare 51990 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.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$623.90
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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 51990 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
6,102
- Code
- 51990
- Physician work
- 13.03
- Practice expense
- 5.35
- Malpractice
- 1.71
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.03 | × 1.000 | 13.0300 |
| Practice expense | 5.35 | × 0.875 | 4.6812 |
| Malpractice | 1.71 | × 0.566 | 0.9679 |
| Total RVUs | 18.6791 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$623.90
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.03 | 1 |
| Practice expense | 5.35 | 0.875 |
| Malpractice | 1.71 | 0.566 |
(13.03 × 1 + 5.35 × 0.875 + 1.71 × 0.566) × $33.4009 = $623.90
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.
51990 billing questions
How is 51990 different from 51992?
51990 describes laparoscopic urethral suspension, typically a suture-based colposuspension. Use 51992 when the surgeon performs a laparoscopic sling operation.
Are related preoperative and postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90.
Should modifier 50 be added for bilateral work?
No. Report the suspension as a single service; modifier 50 is inappropriate for this code.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What operative documentation supports 51990?
Document the laparoscopic access, the suspension technique, and the tissues secured to pelvic support structures. The note should make clear that a sling operation was not performed instead.
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.
6,09951940,,Correction of bladder defect,A,,29.89,9.88,NA,9.88,,3.85,43.62,43.62,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,10051960,,Revision of bladder & bowel,A,,24.77,9.08,NA,9.08,,3.18,37.03,37.03,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,10151980,,Construct bladder opening,A,,12.26,5.54,NA,5.54,,1.57,19.37,19.37,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,10251990,,Laparo urethral suspension,A,,13.03,5.35,NA,5.35,,1.71,20.09,20.09,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,10351992,,Laparo sling operation,A,,14.50,5.47,NA,5.47,,2.38,22.35,22.35,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,10451999,,Unlisted laps px bladder,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,0,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6,10552000,,Cystourethroscopy,A,,1.49,4.77,,0.44,,0.20,6.46,2.13,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515