Billing code 51800: Bladder outlet reconstructionMedicare rate & RVUs in Florida
Reports reconstructive surgery reshaping the bladder neck and adjoining urethral outlet, including a wedge resection when performed as part of the repair.
CMS doesn’t publish an office rate for 51800 in Florida.
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 51800 covers
A urologist uses this code for reconstructive surgery at the bladder neck and adjoining urethral outlet, which may include removing a wedge of bladder-neck tissue. The procedure is performed in an operating room to correct an outlet abnormality requiring reconstruction, rather than to suspend the bladder neck for support or simply close a bladder wound.
Select the code from the operative report’s description of the reconstructed anatomy and technique. Documentation should identify the indication, the bladder-neck and urethral work performed, and any wedge resection. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this code. Assistant-at-surgery payment may be made; 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.
Where 51800 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $998.26 |
| Miami | Unavailable | $1,061.96 |
| Rest Of Florida | Unavailable | $960.61 |
How the 51800 rate is calculated
Each of 51800’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 · 51800
RVUs × geographic indexes × conversion factor
Work18.42
18.42 RVUs× 1.000 GPCI
Practice expense7.09
7.09 RVUs× 1.000 GPCI
Malpractice2.37
2.37 RVUs× 1.000 GPCI
Adjusted RVUs
27.8800
Conversion factor
$33.4009
Medicare rate
$931.22
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 51800
51800 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 51800
Bladder outlet reconstruction
| 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 · 51800
Bladder outlet reconstruction
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
51800 without 51 · national facility
$931.22
Bladder outlet reconstruction
51800-51 · Second procedure: 50%
$465.61
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%).
51800 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 51820Outlet reconstruction
- This code addresses bladder-neck and adjoining urethral reconstruction. Compare the operative extent documented for 51820, which describes a different urinary-tract reconstruction.
- 51840Bladder suspension
- Use 51800 for reconstructive work at the bladder outlet; 51840 describes a bladder-neck suspension intended to provide support.
- 51841Bladder suspension
- 51841 is a suspension procedure with a sling. Choose 51800 when the operative report describes reconstruction of the outlet rather than sling-based support.
- 51860Bladder repair
- 51860 is for repair of a bladder wound. It is not the same as reconstructing the bladder neck and adjoining urethral outlet.
51800 billing questions
How is this different from bladder-neck suspension?
This code describes reconstruction of the bladder-neck and adjoining urethral outlet. A suspension code is considered when the operative objective is to support the bladder neck or urethra, such as for stress urinary incontinence.
What documentation supports reporting this code?
The operative report should describe the outlet abnormality, the anatomy reconstructed, and the surgical steps, including whether a bladder-neck wedge was removed. The documented work should establish reconstruction rather than suspension or wound closure.
Are related postoperative visits included?
Yes. Medicare’s 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used?
No. The procedure is not treated as bilateral for payment adjustment, and modifier 50 is not appropriate.
How are other procedures in the same session paid?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction.
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 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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