No office rate
This code addresses a bladder-to-uterus fistula. Code 51900 is for a bladder-to-vagina fistula repaired through a vaginal approach.
On this page
CMS RVU26D · Effective 2026-10-01
51920 Fistula repair Medicare reimbursement rates in Arizona
Reports operative closure of an abnormal connection between the bladder and uterus, such as a fistula following cesarean delivery or pelvic surgery. Compare 51920 office and facility rates across CMS payment localities in Arizona.
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 51920 in Arizona?
Arizona 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
$678.45
1 of 1 localities have a supported rate.
Payment area: Arizona
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.
Urologic surgery
About 51920: Vesicouterine fistula closure
Reports operative closure of an abnormal connection between the bladder and uterus, such as a fistula following cesarean delivery or pelvic surgery.
This code is for surgical closure of a vesicouterine fistula, an abnormal passage connecting the bladder and uterus. These fistulas may follow cesarean delivery or other pelvic surgery and can cause urine to pass through the uterus. A urologist or gynecologic surgeon may perform the repair in a hospital or other surgical setting. The operative report should establish that the communication is between the bladder and uterus and describe its closure.
Select this code for the vesicouterine fistula repair, rather than a repair directed at a bladder-vaginal fistula or a nonfistulous bladder defect. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one 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 anatomy. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 51920
- 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 RVU13.07 · 63%
- Practice expense (office) RVU5.99 · 29%
- Malpractice RVU1.68 · 8%
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.
51920 compared with similar codes
Office rates for Arizona, from the same CMS release.
No office rate
Code 51925 describes bladder-vaginal fistula repair with hysterectomy. Use this code for a bladder-to-uterus fistula, based on the documented anatomy and operation.
No office rate
Code 51940 concerns correction of a bladder defect, not closure of a fistulous connection between the bladder and uterus.
Compare 51920 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
Arizona →
Office / nonfacility
Unavailable
Facility
$678.45
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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 51920 in Arizona.
PPRRVU2026_Oct_nonQPP.csv
6,097
- Code
- 51920
- Physician work
- 13.07
- Practice expense
- 5.99
- Malpractice
- 1.68
GPCI2026.csv
6
- Locality
- Arizona
- Physician work
- 1.000
- Practice expense
- 0.969
- Malpractice
- 0.856
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.07 | × 1.000 | 13.0700 |
| Practice expense | 5.99 | × 0.969 | 5.8043 |
| Malpractice | 1.68 | × 0.856 | 1.4381 |
| Total RVUs | 20.3124 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arizona$678.45
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.07 | 1 |
| Practice expense | 5.99 | 0.969 |
| Malpractice | 1.68 | 0.856 |
(13.07 × 1 + 5.99 × 0.969 + 1.68 × 0.856) × $33.4009 = $678.45
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.
51920 billing questions
How is this different from a vesicovaginal fistula repair?
Use this code when the fistula connects the bladder and uterus. A bladder-to-vagina fistula is a different anatomic repair; the approach and any accompanying procedure also matter when selecting its code.
Does this code include a hysterectomy?
The code identifies closure of a vesicouterine fistula. Document any hysterectomy separately as a distinct performed service and select its code based on the actual operation.
Can modifier 50 be used?
No. Bilateral adjustment is inappropriate for this code’s descriptor and anatomy.
What documentation supports reporting this code?
The operative report should identify the bladder-to-uterus fistula and describe the surgical closure. Include the clinical context, such as a fistula following pelvic surgery, when documented.
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 in the session are subject to reduction. Related postoperative care is included in this code’s 90-day global period.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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 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.
6,09451865,,Repair of bladder wound,A,,15.41,6.63,NA,6.63,,2.21,24.25,24.25,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09551880,,Repair of bladder opening,A,,7.67,4.08,NA,4.08,,1.11,12.86,12.86,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09651900,,Repair bladder/vagina lesion,A,,14.26,6.22,NA,6.22,,1.83,22.31,22.31,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09751920,,Close bladder-uterus fistula,A,,13.07,5.99,NA,5.99,,1.68,20.74,20.74,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09851925,,Hysterectomy/bladder repair,A,,17.09,8.22,NA,8.22,,3.00,28.31,28.31,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09951940,,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
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
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536