No office rate
Use 53440 to place a male sling. Use 53442 when the surgeon removes or revises an existing male sling.
On this page
CMS RVU26D · Effective 2026-10-01
53442 Male sling surgery Medicare reimbursement rates in Hawaii
Reports operative removal or revision of an implanted male sling, commonly performed when it causes symptoms, complications, or inadequate control of stress incontinence. Compare 53442 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 53442 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
$722.93
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.
Urology surgery
About 53442: Male sling removal or revision
Reports operative removal or revision of an implanted male sling, commonly performed when it causes symptoms, complications, or inadequate control of stress incontinence.
This service covers operative removal or revision of an implanted male sling used to support the urethra and manage stress urinary incontinence, often after prostate surgery. A urologist typically performs the work in an operating-room setting when the sling requires correction or removal because of inadequate continence, device-related symptoms, or a complication. It is distinct from placing a new sling and from surgery on an artificial urinary sphincter.
Report 53442 when the surgeon works on an existing male sling, and document the device, reason for intervention, and specific removal or revision performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate for this service.
CMS billing rules for 53442
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.15 · 61%
- Practice expense (office) RVU6.61 · 31%
- Malpractice RVU1.69 · 8%
48
Medicare services in 2024 · #5380 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.
53442 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
53446 concerns removal of an artificial urinary sphincter; 53442 concerns removal or revision of a male sling.
No office rate
53447 describes removing and replacing an artificial urinary sphincter. It is not the code for revision or removal of a male sling.
53450
No office rateUrethral revision
53450 is for revision of the urethra itself. Use 53442 when the operative work targets an implanted male sling.
Compare 53442 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
$722.93
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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 53442 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
6,200
- Code
- 53442
- Physician work
- 13.15
- Practice expense
- 6.61
- Malpractice
- 1.69
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.15 | × 1.000 | 13.1500 |
| Practice expense | 6.61 | × 1.137 | 7.5156 |
| Malpractice | 1.69 | × 0.579 | 0.9785 |
| Total RVUs | 21.6441 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$722.93
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.15 | 1 |
| Practice expense | 6.61 | 1.137 |
| Malpractice | 1.69 | 0.579 |
(13.15 × 1 + 6.61 × 1.137 + 1.69 × 0.579) × $33.4009 = $722.93
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.
53442 billing questions
How does 53442 differ from 53440?
53442 is for operating on an existing male sling to remove or revise it. Use 53440 for insertion of a male sling.
Is 53442 used for an artificial urinary sphincter?
No. This code concerns a male sling. Use the device-specific code when the operation is on an artificial urinary sphincter.
What documentation supports reporting 53442?
Document the implanted sling, the clinical reason for intervention, and whether the surgeon removed or revised it. The operative note should describe the work performed.
Can an assistant at surgery be reported?
CMS indicates that assistant-at-surgery payment may be made. Co-surgeon and team-surgery billing are not permitted for this code.
What global period applies?
The code has a 90-day global period. The day-before preoperative visit and related postoperative care during the period are included.
How is 53442 paid with another procedure in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are subject to a 50% 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.
6,19753430,,Reconstruction of urethra,A,,16.99,6.71,NA,6.71,,2.44,26.14,26.14,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19853431,,Reconstruct urethra/bladder,A,,20.65,7.55,NA,7.55,,2.65,30.85,30.85,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19953440,,Male sling procedure,A,,13.03,5.70,NA,5.70,,1.67,20.40,20.40,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20053442,,Remove/revise male sling,A,,13.15,6.61,NA,6.61,,1.69,21.45,21.45,0,090,0.08,0.83,0.09,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20153444,,Insert tandem cuff,A,,13.84,5.85,NA,5.85,,1.77,21.46,21.46,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20253445,,Insert uro/ves nck sphincter,A,,12.68,6.33,NA,6.33,,1.63,20.64,20.64,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20353446,,Remove uro sphincter,A,,10.74,5.47,NA,5.47,,1.37,17.58,17.58,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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