Billing code 53515: Urethral repairMedicare rate & RVUs in Delaware
Reports operative reconstruction of a complicated urethral injury in a male patient, such as a substantial traumatic disruption requiring complex repair.
CMS doesn’t publish an office rate for 53515 in Delaware.
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 53515 covers
A urologist typically performs this repair in an operating room to reconstruct a complicated injury of the male urethra. A pelvic fracture-associated urethral disruption is one clinical context in which operative reconstruction may be considered. The work goes beyond a simple repair; the operative report should make the injury’s extent and the complexity of reconstruction clear.
Select this code for a complicated male urethral injury repair, rather than the simple male repair code. Document the injury site and extent, operative findings, and repair performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. A bilateral adjustment is inappropriate. An assistant at surgery may be paid; 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.
53515 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $711.78 |
How the 53515 rate is calculated
Each of 53515’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 · 53515
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.86Practice expense 5.86Malpractice 1.77
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 53515
53515 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53515
Urethral repair
| 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 · 53515
Urethral repair
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
53515 without 51 · national facility
$717.79
Urethral repair
53515-51 · Second procedure: 50%
$358.90
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%).
53515 compared with similar codes
Compare codes
53515 vs 53510 vs 53505 vs 53502: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 53510Urethral injury repair
- Use 53510 for a simple male urethral injury repair. This code is for a complicated male repair, supported by the operative findings and work documented.
- 53505Urethral repair
- This code is for complicated male urethral injury repair; 53505 is the corresponding complicated repair for female urethral anatomy.
- 53502Urethral repair
- 53502 describes simple female urethral injury repair. The patient anatomy and repair complexity distinguish it from this complicated male repair.
53515 billing questions
How does this differ from 53510?
53515 is for a complicated male urethral injury repair; 53510 is the simple male repair. The operative documentation should support the complexity distinction.
Can modifier 50 be used for a bilateral repair?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Are related postoperative visits separately reported?
The 90-day global period includes related postoperative care, as well as the day-before preoperative visit.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure reduction.
What documentation supports reporting the complicated repair?
Record the injury location and extent, operative findings, and repair performed so the complexity is distinguishable from a simple male repair.
Can 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 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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