Billing code 53621: Urethral dilationMedicare rate & RVUs in Delaware

Reports a subsequent dilation of a female urethral stricture using sounds or dilators, when the service follows the initial dilation.

CMS RVU26DEffective Oct 1, 20261 payment locality570 Medicare services in 2024

Medicare pays $165.24 for 53621 in the office in Delaware (Delaware). Which amount applies depends on the service address.

$165.24Office (non-facility)
$63.27Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 53621 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Delaware
  2. What 53621 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 53621 covers

This code applies to a subsequent urethral stricture dilation in a female patient using sounds or dilators to widen the narrowed urethral passage. A urologist typically performs the procedure in an office or outpatient facility. It is distinct from dilation of a female urethra when a urethral stricture is not the condition being treated.

Select the subsequent-service code rather than the initial-service code based on where the dilation falls in the treatment sequence, not the stricture’s severity. Document the stricture, the patient’s anatomy, the dilation performed, and why this was a subsequent service. The 0-day global period includes same-day preoperative and 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% multiple-procedure reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgery and team-surgery payment are 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.

53621 in Delaware

53621 office and facility rates by payment locality
Payment localityOfficeFacility
Delaware$165.24$63.27

How the 53621 rate is calculated

Each of 53621’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 · 53621

RVUs × geographic indexes × conversion factor

Work1.32

1.32 RVUs× 1.000 GPCI

Practice expense3.51

3.51 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

5.0000

Conversion factor

$33.4009

Medicare rate

$167.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 53621

The CMS indicators that decide how 53621 is paid alongside other services.

CMS payment indicators · 53621

Urethral dilation

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

53621 without 51 · national office

$167.00

Urethral dilation

53621-51 · Second procedure: 50%

$83.50

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%).

When to use modifier 51

53621 compared with similar codes

Compare codes · National

4 codes, side by side

  • 53621

    Urethral dilation1.32 wRVU

    $167.00

  • 53620

    Urethral dilation1.58 wRVU

    $173.68+$6.68

  • 53601

    Urethral dilation0.96 wRVU

    $89.51−$77.49

  • 53661

    Urethral dilation0.7 wRVU

    $77.49−$89.51

How to choose

53620Urethral dilation
Both apply to female urethral stricture dilation. Choose 53620 for the initial dilation and 53621 for a subsequent dilation.
53601Urethral dilation
This is the subsequent-service code for male urethral stricture dilation; 53621 is for a female patient.
53661Urethral dilation
This belongs to the separate series for female urethral dilation. Use 53621 when treating a female urethral stricture with a subsequent dilation.

53621 billing questions

How does this differ from 53620?

53620 is the initial dilation code for a female urethral stricture. Use 53621 for a subsequent dilation in the treatment sequence.

Can 53621 be reported for a male patient?

No. This code is for subsequent dilation of a female urethral stricture; male stricture dilation is coded in the male-specific code series.

How does this differ from 53661?

53621 concerns a urethral stricture and a subsequent dilation. Code 53661 is in the separate series for female urethral dilation.

Should modifier 50 be appended?

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

What same-day care is included?

The 0-day global period includes same-day preoperative and postoperative care. Other procedures performed in the same session may be subject to the standard multiple-procedure reduction.

What documentation supports reporting 53621?

Document the female patient’s urethral stricture, the dilation performed with sounds or dilators, and why the service is subsequent rather than initial.

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
RVUs for 53621PPRRVU2026_Oct_nonQPP.csv, line 6,223 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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