FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

51535 Ureterocele repair Medicare reimbursement rates in Guam

Reports surgical treatment of a ureterocele through a bladder incision, rather than endoscopic incision of the ureterocele through the urethra. Compare 51535 office and facility rates across CMS payment localities in Guam.

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 51535 in Guam?

Guam 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

No supported rate

Facility setting

$706.50

1 of 1 localities have a supported rate.

Payment area: Hawaii, Guam

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.

Find 51535 in your payment locality →

Urologic surgery

About 51535: Ureterocele excision through cystotomy

Reports surgical treatment of a ureterocele through a bladder incision, rather than endoscopic incision of the ureterocele through the urethra.

A urologist uses a surgical bladder opening to expose and excise a ureterocele, a dilation of the distal ureter that protrudes into the bladder. This approach may be used when the ureterocele requires operative treatment, such as for urinary obstruction or recurrent infection. The service is generally performed in an operating room, with the operative report identifying the ureterocele and the surgical approach.

Report the code for the cystotomy-based excision, not for endoscopic incision through the urethra. Document the treated side or sides, the ureterocele, and the work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 51535

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 procedure with modifier 50 is paid at 150%.
Assistant at surgery
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU13.55 · 64%
  • Practice expense (office) RVU5.80 · 28%
  • Malpractice RVU1.74 · 8%

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.

51535 compared with similar codes

Office rates for Guam, from the same CMS release.

52301

Ureterocele treatment

Cystoscopic incision or resection

No office rate

Use 52301 for endoscopic incision of a ureterocele through the urethra. Use 51535 when the ureterocele is treated by excision through cystotomy.

51520

Bladder diverticulectomy

Via cystotomy

No office rate

51520 addresses a bladder lesion through cystotomy. This code is for a ureterocele, a lesion involving the distal ureter at the bladder.

51525

Bladder surgery

Diverticulum excision

No office rate

51525 is for excision of a bladder diverticulum through cystotomy. It does not describe excision of a ureterocele.

51530

Bladder tumor excision

Open cystotomy approach

No office rate

51530 describes cystotomy treatment of bladder tumor(s). Choose this code for ureterocele excision instead when that is the operative target.

Compare 51535 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

Office and facility base rates · shared scale starting at $0

Need rates for a whole code list?

Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.

Explore fee-sheet early access →

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 51535 in Hawaii, Guam.

PPRRVU2026_Oct_nonQPP.csv

6,030

Code
51535
Physician work
13.55
Practice expense
5.80
Malpractice
1.74

GPCI2026.csv

46

Locality
Hawaii, Guam
Physician work
1.000
Practice expense
1.137
Malpractice
0.579
Facility calculation for 51535 in Hawaii, Guam
ComponentRVULocality factorAdjusted
Physician work13.55× 1.00013.5500
Practice expense5.80× 1.1376.5946
Malpractice1.74× 0.5791.0075
Total RVUs21.1521
Conversion factor× 33.4009

Facility rate, Hawaii, Guam$706.50

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work13.551
Practice expense5.81.137
Malpractice1.740.579

(13.55 × 1 + 5.8 × 1.137 + 1.74 × 0.579) × $33.4009 = $706.50

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.

51535 billing questions

How does this differ from endoscopic ureterocele treatment?

This code describes excision through a surgical bladder incision. CPT 52301 is the endoscopic alternative for incision of a ureterocele through the urethra.

Can bladder lesion or diverticulum codes be used instead?

No. Select the code that matches the operative target and work: this service treats a ureterocele, while bladder lesion and diverticulum codes describe different procedures.

What documentation supports reporting this code?

The operative report should identify the ureterocele, the side treated, the cystotomy-based approach, and the excision or repair performed.

How is bilateral treatment reported?

For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.

What payment rules apply when other procedures are performed in the same session?

The highest-valued procedure is paid in full and the other procedures are paid at 50%. The 90-day global period includes the day-before preoperative visit and related postoperative care.

May 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 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.

RVUs for 51535PPRRVU2026_Oct_nonQPP.csv, line 6,030 (RVU26D)
Geographic factors for Hawaii, GuamGPCI2026.csv, line 46 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet