Billing code 53265: Urethral treatmentMedicare rate & RVUs in Alaska
Reports treatment directed at a urethral lesion, rather than diagnostic sampling alone or a separately described lesion-removal procedure.
Medicare pays $283.51 for 53265 in the office in Alaska (Alaska*). Which amount applies depends on the service address.
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 9 sections
What 53265 covers
billing code 53265 represents treatment directed at a lesion of the urethra. A urologist may perform the service in an office or facility after identifying a lesion during evaluation of urethral symptoms or endoscopic assessment. The note should identify the lesion’s location and describe the treatment performed. The code label alone does not establish that the lesion is a caruncle, polyp, or another specific type, so the documented service must support this code rather than a more specifically described procedure.
The code has a 10-day global period, which includes related postoperative visits during that period. 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 multiple procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted. Documentation should support the urethral site, the lesion treated, and the service performed.
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.
53265 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | $283.51 | $218.42 |
How the 53265 rate is calculated
Each of 53265’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 · 53265
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.09Practice expense 3.38Malpractice 0.46
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 53265
53265 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53265
Urethral treatment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are 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. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 53265
Urethral treatment
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
53265 without 51 · national office
$231.47
Urethral treatment
53265-51 · Second procedure: 50%
$115.74
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%).
53265 compared with similar codes
Compare codes
53265 vs 53200 vs 53220 vs 53230 vs 53235: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 53200Urethral biopsy
- 53200 is for biopsy of the urethra to obtain tissue; 53265 is for treating a lesion.
- 53220Urethral lesion treatment
- Both carry a CMS short descriptor for urethral-lesion treatment. Confirm the full billing code descriptor and the documented service when distinguishing them.
- 53230Lesion excision
- 53230 is identified as removal of a urethral lesion; 53265 is identified as treatment of a urethral lesion.
- 53235Urethral excision
- 53235 is identified as removal of a urethral lesion; 53265 is identified as treatment of a urethral lesion.
53265 billing questions
When should 53265 be chosen instead of a urethral biopsy code?
Use 53265 for treatment of the lesion. Use 53200 when the service is a biopsy to obtain tissue for diagnosis.
How does 53265 differ from urethral lesion-removal codes?
53265 describes treatment of a urethral lesion. Codes 53230 and 53235 describe removal of a urethral lesion; report the code that matches the documented procedure.
Are related postoperative visits separately included?
Related postoperative visits during the 10-day global period are included in 53265.
Can modifier 50 be used for treatment on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 53265. Co-surgeons and team surgery are not permitted.
What happens if another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.
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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