No office rate
Choose 53445 for sphincter insertion without removal of an existing device; 53447 includes both removal and replacement.
On this page
CMS RVU26D · Effective 2026-10-01
53447 Sphincter replacement Medicare reimbursement rates in Colorado
Reported when a surgeon removes an existing artificial urinary sphincter and replaces the complete device, rather than replacing a component alone. Compare 53447 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 53447 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
$736.58
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 surgery
About 53447: Remove and replace urinary sphincter
Reported when a surgeon removes an existing artificial urinary sphincter and replaces the complete device, rather than replacing a component alone.
A urologist removes an implanted artificial urinary sphincter and places a replacement system, including its principal device components. This operation may be performed when an existing system requires replacement, such as after device failure or another complication that makes continued use unsuitable. It is generally performed in an operating-room setting; the operative report should identify the existing device, the reason for replacement, and the components removed and implanted.
Report this code for complete device removal and replacement, not removal alone, insertion without removal, or replacement of an individual component. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is not appropriate for this single-device service. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 53447
- 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 RVU13.92 · 64%
- Practice expense (office) RVU6.18 · 28%
- Malpractice RVU1.78 · 8%
847
Medicare services in 2024 · #3098 by national volume
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.
53447 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
53446 covers removal alone. When a replacement system is also implanted during the service, consider 53447.
No office rate
53448 is for removal and replacement of a component, while 53447 represents replacement of the complete urinary sphincter system.
No office rate
53449 describes sphincter repair. Use 53447 when the service removes the existing system and replaces it rather than repairing it.
Compare 53447 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
$736.58
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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 53447 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
6,204
- Code
- 53447
- Physician work
- 13.92
- Practice expense
- 6.18
- Malpractice
- 1.78
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.92 | × 1.012 | 14.0870 |
| Practice expense | 6.18 | × 1.064 | 6.5755 |
| Malpractice | 1.78 | × 0.781 | 1.3902 |
| Total RVUs | 22.0527 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$736.58
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.92 | 1.012 |
| Practice expense | 6.18 | 1.064 |
| Malpractice | 1.78 | 0.781 |
(13.92 × 1.012 + 6.18 × 1.064 + 1.78 × 0.781) × $33.4009 = $736.58
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.
53447 billing questions
When is 53447 reported instead of 53445?
Use 53447 when the existing urinary sphincter is removed and a replacement system is implanted. Code 53445 describes insertion without removal of an existing sphincter.
How does 53447 differ from 53448?
53447 represents removal and replacement of the complete system. Use 53448 when the operative service is limited to removal and replacement of a component.
Can removal be billed separately with 53447?
Removal is part of the complete removal-and-replacement service. Do not separately report removal alone for the same device work.
What documentation supports reporting 53447?
Document the indication for replacement, the existing sphincter removed, the replacement system implanted, and the components addressed during surgery.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can 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 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.
6,20153444,,Insert tandem cuff,A,,13.84,5.85,NA,5.85,,1.77,21.46,21.46,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20253445,,Insert uro/ves nck sphincter,A,,12.68,6.33,NA,6.33,,1.63,20.64,20.64,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20353446,,Remove uro sphincter,A,,10.74,5.47,NA,5.47,,1.37,17.58,17.58,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20453447,,Remove/replace ur sphincter,A,,13.92,6.18,NA,6.18,,1.78,21.88,21.88,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20553448,,Remov/replc ur sphinctr comp,A,,22.85,8.43,NA,8.43,,2.94,34.22,34.22,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20653449,,Repair uro sphincter,A,,10.30,5.12,NA,5.12,,1.33,16.75,16.75,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20753450,,Revision of urethra,A,,6.60,3.89,NA,3.89,,0.86,11.35,11.35,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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