$165.24
Both are female stricture-dilation services; 53620 is the initial service, while 53621 is used for a subsequent dilation.
On this page
CMS RVU26D · Effective 2026-10-01
53620 Urethral dilation Medicare reimbursement rates in Delaware
Reports the initial instrument-based widening of a documented female urethral stricture, typically performed by a urologist in an office or outpatient setting. Compare 53620 office and facility rates across CMS payment localities in Delaware.
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 53620 in Delaware?
Delaware 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
$171.90
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$76.53
1 of 1 localities have a supported rate.
Payment area: Delaware
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 53620: Initial female urethral stricture dilation
Reports the initial instrument-based widening of a documented female urethral stricture, typically performed by a urologist in an office or outpatient setting.
A urologist or other qualified physician uses a sound or urethral dilator to widen a narrowed segment of the female urethra. The procedure may be performed in an office or outpatient facility when a urethral stricture is being treated; it is distinct from general female urethral dilation without a stricture-specific service. Documentation should identify the stricture and describe the dilation performed.
Use this code for the initial dilation in the treatment sequence; code 53621 is the subsequent-service counterpart. The record should support that this is the initial service and include the clinical indication and procedural details. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. 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 multiple-procedure reduction. Modifier 50 is not appropriate for this urethral service. CMS does not pay assistant-at-surgery services for this code, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 53620
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU1.58 · 30%
- Practice expense (office) RVU3.42 · 66%
- Malpractice RVU0.20 · 4%
982
Medicare services in 2024 · #2984 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.
53620 compared with similar codes
Office rates for Delaware, from the same CMS release.
$90.31
This is the initial stricture-dilation code for a male patient. Code 53620 is for a female patient.
$78.03
Code 53620 describes initial dilation in the female urethral stricture series. Code 53660 is from the separate female urethral dilation series.
Compare 53620 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
Delaware →
Office / nonfacility
$171.90
Facility
$76.53
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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 53620 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
6,222
- Code
- 53620
- Physician work
- 1.58
- Practice expense
- 3.42
- Malpractice
- 0.20
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.58 | × 1.005 | 1.5879 |
| Practice expense | 3.42 | × 0.988 | 3.3790 |
| Malpractice | 0.20 | × 0.899 | 0.1798 |
| Total RVUs | 5.1467 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$171.90
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.58 | 1.005 |
| Practice expense | 3.42 | 0.988 |
| Malpractice | 0.2 | 0.899 |
(1.58 × 1.005 + 3.42 × 0.988 + 0.2 × 0.899) × $33.4009 = $171.90
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.58 | 1.005 |
| Practice expense | 0.53 | 0.988 |
| Malpractice | 0.2 | 0.899 |
(1.58 × 1.005 + 0.53 × 0.988 + 0.2 × 0.899) × $33.4009 = $76.53
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.
53620 billing questions
When should 53620 be chosen over 53621?
Use 53620 for the initial female urethral stricture dilation in the treatment sequence. Use 53621 for a subsequent dilation.
How is this different from 53660?
Code 53620 is for initial dilation of a documented female urethral stricture. Code 53660 belongs to the female urethral dilation series outside this stricture-specific sequence.
Can modifier 50 be reported?
No. This urethral service is not reported as a bilateral procedure.
Is same-day evaluation and postoperative care separately included?
The code has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant-at-surgery service for this code. Co-surgeon and team-surgery reporting are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard 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.
6,21953600,,Dilate urethra stricture,A,,1.18,1.40,,0.35,,0.15,2.73,1.68,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,22053601,,Dilate urethra stricture,A,,0.96,1.60,,0.35,,0.12,2.68,1.43,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,22153605,,Dilate urethra stricture,A,,1.25,0.26,NA,0.26,,0.16,1.67,1.67,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,22253620,,Dilate urethra stricture,A,,1.58,3.42,,0.53,,0.20,5.20,2.31,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,22353621,,Dilate urethra stricture,A,,1.32,3.51,,0.42,,0.17,5.00,1.91,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,22453660,,Dilation of urethra,A,,0.69,1.59,,0.35,,0.08,2.36,1.12,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,22553661,,Dilation of urethra,A,,0.70,1.54,,0.30,,0.08,2.32,1.08,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503