Billing code 53445: Artificial sphincterMedicare rate & RVUs in Alaska
Reports surgical implantation of an inflatable urinary sphincter, including its cuff, pump, and reservoir, for selected patients with severe urinary incontinence.
CMS doesn’t publish an office rate for 53445 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 53445 covers
A urologist typically performs this operation in a hospital or ambulatory surgery setting for severe urinary incontinence caused by inadequate urethral sphincter closure. A common clinical situation is persistent stress incontinence after prostate surgery. The surgeon implants an inflatable system with a cuff around the urethra or bladder neck, a control pump, and a fluid reservoir; the patient operates the pump to allow urination.
Report this code for implantation of the sphincter system, not for later removal, replacement, repair, or adjustment. The operative report should identify the indication, device placement, and components implanted. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one 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.
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.
53445 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $890.45 |
How the 53445 rate is calculated
Each of 53445’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 · 53445
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 12.68Practice expense 6.33Malpractice 1.63
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 53445
53445 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53445
Artificial sphincter
| 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 · 53445
Artificial sphincter
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
53445 without 51 · national facility
$689.39
Artificial sphincter
53445-51 · Second procedure: 50%
$344.70
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%).
53445 compared with similar codes
Compare codes
53445 vs 53444 vs 53440 vs 53447: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 53444Tandem cuff
- 53445 reports implantation of the sphincter system; 53444 reports an additional tandem cuff and is used as an add-on when that cuff is placed.
- 53440Male sling
- 53440 is for a male sling procedure. Choose 53445 when the surgeon implants an inflatable cuff, pump, and reservoir system.
- 53447Sphincter replacement
- 53447 applies when an existing urinary sphincter is removed and replaced. Use 53445 for implantation rather than removal and replacement of a prior device.
53445 billing questions
How is this different from the male sling code?
Report 53445 for implantation of an inflatable cuff-and-pump sphincter system. The male sling code 53440 describes a sling procedure, a different surgical approach to male stress incontinence.
Can a tandem cuff be reported with this implantation?
Code 53444 describes insertion of a tandem cuff and is an add-on to the sphincter implantation when that additional cuff is placed. The operative documentation should support the additional cuff.
Does this code include removal or replacement of an existing device?
No. Use the applicable removal, replacement, or component-replacement code when that is the service performed; 53445 describes implantation of the sphincter system.
Should modifier 50 be appended for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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 subject to a 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation.
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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