No office rate
This code is for the male external procedure; 53010 is its related external urethrotomy code for a different patient anatomy.
On this page
CMS RVU26D · Effective 2026-10-01
53000 Urethrotomy Medicare reimbursement rates in Colorado
External urethrotomy for a male urethral narrowing is reported when the surgeon incises the urethra through an external surgical approach. Compare 53000 office and facility rates across CMS payment localities in Colorado.
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 53000 in Colorado?
Colorado 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
$140.90
1 of 1 localities have a supported rate.
Payment area: Colorado
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.
Urology procedure
About 53000: Male external urethral incision
External urethrotomy for a male urethral narrowing is reported when the surgeon incises the urethra through an external surgical approach.
A urologist performs this procedure by surgically accessing and incising the male urethra from outside its lumen, typically to address an obstructing urethral stricture. It is distinct from an endoscopic incision made through a cystoscope. The operative report should identify the narrowing, its location, the external approach, and the incision performed.
Report this code for the male external procedure, not for an internal endoscopic urethrotomy or an incision limited to the urethral meatus. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 53000
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.27 · 55%
- Practice expense (office) RVU1.60 · 39%
- Malpractice RVU0.28 · 7%
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.
53000 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
Use 53000 for external surgical access. Use 52276 when the urethral incision is performed internally through a cystoscope.
No office rate
53020 addresses a procedure limited to the urethral meatus, rather than an external incision of the male urethra.
No office rate
Compare the procedure and patient circumstance: 53025 is a meatotomy code, while 53000 describes external urethral incision.
Compare 53000 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
Colorado →
Office / nonfacility
Unavailable
Facility
$140.90
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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 53000 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
6,171
- Code
- 53000
- Physician work
- 2.27
- Practice expense
- 1.60
- Malpractice
- 0.28
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.27 | × 1.012 | 2.2972 |
| Practice expense | 1.60 | × 1.064 | 1.7024 |
| Malpractice | 0.28 | × 0.781 | 0.2187 |
| Total RVUs | 4.2183 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$140.90
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.27 | 1.012 |
| Practice expense | 1.6 | 1.064 |
| Malpractice | 0.28 | 0.781 |
(2.27 × 1.012 + 1.6 × 1.064 + 0.28 × 0.781) × $33.4009 = $140.90
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.
53000 billing questions
How does this differ from an endoscopic urethrotomy?
This code describes external surgical access to the male urethra. An incision made internally through a cystoscope is a different procedure, such as the service represented by 52276.
Can this code be used for a narrowing confined to the urethral opening?
No. A meatotomy code is the closer choice when the procedure is limited to cutting the urethral meatus; 53020 and 53025 distinguish the applicable patient or procedure circumstance.
Are related postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in this procedure's payment.
Should modifier 50 be appended for bilateral work?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this service. Co-surgeon and team-surgery billing are not permitted.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard 50% multiple-procedure reduction.
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.
6,16852648,,Laser surgery of prostate,A,,9.80,4.75,NA,4.75,,1.27,15.82,15.82,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,16952649,,Prostate laser enucleation,A,,12.68,5.36,NA,5.36,,1.63,19.67,19.67,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17052700,,Drainage of prostate abscess,A,,7.30,3.91,NA,3.91,,0.93,12.14,12.14,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17153000,,Incision of urethra,A,,2.27,1.60,NA,1.60,,0.28,4.15,4.15,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17253010,,Incision of urethra,A,,4.34,3.51,NA,3.51,,0.57,8.42,8.42,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17353020,,Incision of urethra,A,,1.73,0.64,NA,0.64,,0.21,2.58,2.58,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17453025,,Incision of urethra,A,,1.10,0.64,NA,0.64,,0.14,1.88,1.88,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899