Billing code 51597: Pelvic exenterationMedicare rate & RVUs in Georgia
Reports complete pelvic cancer surgery removing the bladder and other pelvic organs, with urinary diversion created as part of the operation.
CMS doesn’t publish an office rate for 51597 in Georgia.
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 51597 covers
Code 51597 represents radical pelvic cancer surgery that removes the bladder and other involved pelvic organs in a single exenterative procedure and includes creation of a urinary diversion. The organs removed depend on the tumor site and extent; resection may involve the rectosigmoid, reproductive organs, or adjacent pelvic structures. Urologic or gynecologic oncologic surgeons typically perform the operation in a hospital operating room, with colorectal expertise when bowel resection is needed.
Report this code for complete exenteration rather than a bladder-only cystectomy. The operative report should identify the malignancy, organs removed, extent of resection, and urinary diversion created. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this central-organ operation. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment 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 51597 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $2,090.03 |
| Rest Of Georgia | Unavailable | $2,027.96 |
How the 51597 rate is calculated
Each of 51597’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 · 51597
RVUs × geographic indexes × conversion factor
Work41.79
41.79 RVUs× 1.000 GPCI
Practice expense13.56
13.56 RVUs× 1.000 GPCI
Malpractice5.73
5.73 RVUs× 1.000 GPCI
Adjusted RVUs
61.0800
Conversion factor
$33.4009
Medicare rate
$2,040.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 51597
51597 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 51597
Pelvic exenteration
| 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 · 51597
Pelvic exenteration
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
51597 without 51 · national facility
$2,040.13
Pelvic exenteration
51597-51 · Second procedure: 50%
$1,020.07
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%).
51597 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 51590Bladder removal
- 51590 describes bladder removal with urinary diversion. Choose 51597 when the operation is a complete pelvic exenteration involving the bladder and other pelvic organs.
- 51595Bladder removal
- 51595 combines bladder removal, urinary diversion, and bilateral pelvic lymphadenectomy; it does not describe the broader multiorgan exenteration reported with 51597.
- 51596Bladder removal
- 51596 describes bladder removal with a continent urinary reservoir. Choose 51597 for complete pelvic exenteration with urinary diversion as part of the broader cancer operation.
51597 billing questions
How is 51597 different from a cystectomy code?
Use 51597 for complete pelvic exenteration for malignancy involving the bladder and other pelvic organs, with urinary diversion. A cystectomy code describes bladder removal with a specified diversion or other features, not the broader exenterative operation.
What operative details support reporting 51597?
Document the malignancy, the organs removed, the extent of the exenteration, and the urinary diversion created. These details distinguish the procedure from bladder-only removal.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this operation because it addresses removal of central pelvic organs as an exenterative procedure.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment 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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