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CMS RVU26D · Effective 2026-10-01

51980 Vesicostomy Medicare reimbursement rates in Connecticut

Reports surgical creation of a bladder opening to the skin for urinary drainage, commonly used when a patient cannot empty the bladder safely through the urethra. Compare 51980 office and facility rates across CMS payment localities in Connecticut.

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 51980 in Connecticut?

Connecticut 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

$680.43

1 of 1 localities have a supported rate.

Payment area: Connecticut

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.

Find 51980 in your payment locality →

Urologic surgery

About 51980: Cutaneous vesicostomy creation

Reports surgical creation of a bladder opening to the skin for urinary drainage, commonly used when a patient cannot empty the bladder safely through the urethra.

A vesicostomy creates a route from the bladder to the skin so urine can drain continuously through an abdominal opening. Pediatric urologists commonly perform the procedure for infants or children who need urinary diversion, such as when bladder outlet obstruction or impaired emptying makes urethral drainage unsuitable. The resulting opening is managed as a urinary stoma and may serve as a temporary diversion or longer-term drainage route, depending on the patient’s condition.

Report the service for creation of the cutaneous bladder opening, rather than for placement of a suprapubic drainage catheter or another form of cystostomy. The operative report should establish that a vesicostomy was constructed and describe the procedure and clinical reason for diversion. This major surgery has a 90-day global period, including the day-before preoperative visit and 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.

CMS billing rules for 51980

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 RVU12.26 · 63%
  • Practice expense (office) RVU5.54 · 29%
  • Malpractice RVU1.57 · 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.

51980 compared with similar codes

Office rates for Connecticut, from the same CMS release.

51040

Bladder drainage

Open cystotomy

No office rate

Choose 51980 when the surgeon constructs a bladder-to-skin opening for drainage. Code 51040 describes cystostomy with drainage, a distinct procedure.

51102

Bladder drainage

Suprapubic catheter insertion

$256.18

Code 51102 describes suprapubic catheter insertion using bladder aspiration. It does not represent construction of a vesicostomy.

51999

Unlisted laps px bladder

No office rate

Code 51999 is for an unlisted laparoscopic bladder procedure when no specific code describes the service. It is not the specific vesicostomy code.

Compare 51980 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

Office and facility base rates · shared scale starting at $0

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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 51980 in Connecticut.

PPRRVU2026_Oct_nonQPP.csv

6,101

Code
51980
Physician work
12.26
Practice expense
5.54
Malpractice
1.57

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Facility calculation for 51980 in Connecticut
ComponentRVULocality factorAdjusted
Physician work12.26× 1.02012.5052
Practice expense5.54× 1.0775.9666
Malpractice1.57× 1.2101.8997
Total RVUs20.3715
Conversion factor× 33.4009

Facility rate, Connecticut$680.43

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work12.261.02
Practice expense5.541.077
Malpractice1.571.21

(12.26 × 1.02 + 5.54 × 1.077 + 1.57 × 1.21) × $33.4009 = $680.43

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.

51980 billing questions

How is a vesicostomy different from a suprapubic catheter?

A vesicostomy creates a bladder-to-skin opening for ongoing drainage. A suprapubic catheter service places a drainage catheter through the abdominal wall rather than constructing a vesicostomy.

Can this code be reported with other procedures performed during the same operation?

It may be reported with separately performed procedures when each service is supported by the operative documentation. The CMS multiple-procedure reduction applies when procedures are performed in the same session: the highest-valued procedure is paid in full and others at 50%.

Should modifier 50 be used for a vesicostomy?

No. The CMS bilateral adjustment does not apply to this procedure, and modifier 50 is inappropriate.

What documentation supports reporting this code?

The operative report should show that the surgeon created a cutaneous opening from the bladder for urine drainage and document the reason urinary diversion was needed.

What postoperative care is included in the global period?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeons are paid only with 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.

RVUs for 51980PPRRVU2026_Oct_nonQPP.csv, line 6,101 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet