Billing code 53405: UrethroplastyMedicare rate & RVUs in Alaska
Reports the second operation in a staged reconstruction of the male anterior urethra, typically tubularizing a healed urethral plate from the first stage.
CMS doesn’t publish an office rate for 53405 in Alaska.
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 53405 covers
A urologist performs this operation to complete a planned two-stage reconstruction of the male anterior urethra. In the first stage, scarred urethral tissue may be opened and a urethral plate established; after healing, the second-stage operation forms that plate into a urethral channel. This approach may be used for complex anterior urethral strictures or reconstruction after failed hypospadias repair. The procedure is generally performed in an operating room.
Report 53405 when the operative plan and record support the second stage of this male anterior reconstruction, rather than a one-stage repair or the initial stage. Documentation should identify the prior staged procedure, the reconstructed urethral segment, and the work performed to complete the reconstruction. CMS assigns a 90-day global period, including 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 others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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.
53405 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $1,026.65 |
How the 53405 rate is calculated
Each of 53405’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 · 53405
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 15.27Practice expense 6.34Malpractice 1.96
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 53405
53405 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53405
Urethroplasty
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 53405
Urethroplasty
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
53405 without 51 · national facility
$787.26
Urethroplasty
53405-51 · Second procedure: 50%
$393.63
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%).
53405 compared with similar codes
Compare codes
53405 vs 53400 vs 53415 vs 53425 vs 53450: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 53400Urethral repair
- Use 53400 for the first stage of the male anterior reconstruction. Use 53405 when the later operation completes that staged repair.
- 53415Urethroplasty
- Both represent a second-stage reconstruction, but 53415 concerns the male posterior urethra; 53405 concerns the male anterior urethra.
- 53425Urethral reconstruction
- 53425 is the second-stage reconstruction for a different patient anatomy. 53405 is for male anterior urethral reconstruction.
- 53450Urethral revision
- 53450 describes urethral revision. Choose 53405 when the documented operation is specifically the second stage of a planned male anterior reconstruction.
53405 billing questions
How is 53405 distinguished from 53400?
53405 is for the second stage of a planned two-stage male anterior urethral reconstruction. 53400 represents the first-stage service.
Can 53405 be reported for a one-stage urethral repair?
No. The record must support completion of a staged reconstruction, not a reconstruction completed in one operation.
Can modifier 50 be used for this procedure?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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 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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