No office rate
51596 describes a continent reservoir. 51590 describes a different diversion, such as a ureteroileal conduit or sigmoid bladder.
On this page
CMS RVU26D · Effective 2026-10-01
51596 Bladder removal Medicare reimbursement rates in Hawaii
Reports complete bladder removal combined with construction of a continent urinary reservoir using bowel, such as a catheterizable pouch or neobladder. Compare 51596 office and facility rates across CMS payment localities in Hawaii.
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 51596 in Hawaii?
Hawaii 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
$2070.81
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.
Urologic surgery
About 51596: Complete cystectomy with continent diversion
Reports complete bladder removal combined with construction of a continent urinary reservoir using bowel, such as a catheterizable pouch or neobladder.
A urologist removes the entire urinary bladder and creates a continent urinary reservoir using a segment of intestine, including the required intestinal anastomosis. The diversion may be a catheterizable pouch, such as an Indiana pouch, or an orthotopic neobladder connected to the urethra. The operation is generally performed in a hospital operating room, often for bladder cancer, and may be part of a larger pelvic operation.
Select this code when the record supports complete cystectomy and a continent diversion; document the reservoir configuration and bowel work. The code includes the intestinal anastomosis involved in creating the diversion. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related 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% reduction. Modifier 50 is inappropriate for this procedure. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 51596
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU43.15 · 69%
- Practice expense (office) RVU13.68 · 22%
- Malpractice RVU5.69 · 9%
184
Medicare services in 2024 · #4396 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.
51596 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
51595 combines complete cystectomy, pelvic lymphadenectomy, and a ureteroileal conduit or sigmoid bladder; 51596 is distinguished by the continent diversion.
No office rate
51570 reports complete cystectomy without the specified continent diversion. Choose 51596 when the operation also creates a continent reservoir.
No office rate
51585 describes complete cystectomy with pelvic lymphadenectomy and ureterosigmoidostomy or sigmoid bladder, rather than a continent reservoir.
Compare 51596 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$2070.81
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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 51596 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
6,040
- Code
- 51596
- Physician work
- 43.15
- Practice expense
- 13.68
- Malpractice
- 5.69
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 43.15 | × 1.000 | 43.1500 |
| Practice expense | 13.68 | × 1.137 | 15.5542 |
| Malpractice | 5.69 | × 0.579 | 3.2945 |
| Total RVUs | 61.9987 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$2070.81
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 43.15 | 1 |
| Practice expense | 13.68 | 1.137 |
| Malpractice | 5.69 | 0.579 |
(43.15 × 1 + 13.68 × 1.137 + 5.69 × 0.579) × $33.4009 = $2070.81
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.
51596 billing questions
When should this code be selected instead of 51590?
Use 51596 for a continent reservoir, such as a catheterizable pouch or orthotopic neobladder. Code 51590 describes a different diversion approach, such as a ureteroileal conduit or sigmoid bladder.
Does the code include the bowel anastomosis?
Yes. The intestinal anastomosis involved in creating the continent diversion is included in 51596.
Does 51596 include pelvic lymphadenectomy?
The code description centers on complete cystectomy with continent diversion and does not specify pelvic lymphadenectomy. Document any lymph node dissection performed and assess it separately under applicable coding guidance.
Can modifier 50 be reported?
No. Bilateral adjustment is inappropriate for this procedure because the descriptor and anatomy do not support modifier 50.
What documentation supports reporting 51596?
The operative report should establish complete bladder removal and describe the continent diversion, including its configuration and intestinal work. Document any associated procedures separately.
How does the global period affect postoperative billing?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others 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.
6,03751585,,Removal of bladder & nodes,A,,38.65,12.33,NA,12.33,,4.96,55.94,55.94,0,090,0.08,0.83,0.09,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,03851590,,Remove bladder/revise tract,A,,35.42,11.12,NA,11.12,,4.71,51.25,51.25,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,03951595,,Remove bladder/revise tract,A,,40.29,12.35,NA,12.35,,5.29,57.93,57.93,0,090,0.08,0.83,0.09,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,04051596,,Remove bladder/create pouch,A,,43.15,13.68,NA,13.68,,5.69,62.52,62.52,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,04151597,,Removal of pelvic structures,A,,41.79,13.56,NA,13.56,,5.73,61.08,61.08,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,04251600,,Injection for bladder x-ray,A,,0.86,5.26,,0.17,,0.09,6.21,1.12,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,04351605,,Preparation for bladder xray,A,,0.62,0.36,NA,0.36,,0.07,1.05,1.05,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014