No office rate
53215 describes total urethral removal in a male patient. This code is for the corresponding procedure in a female patient.
On this page
CMS RVU26D · Effective 2026-10-01
53210 Urethrectomy Medicare reimbursement rates in Idaho
Reports complete removal of the female urethra, including the associated cystostomy, for cases requiring excision beyond a biopsy or localized lesion procedure. Compare 53210 office and facility rates across CMS payment localities in Idaho.
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 53210 in Idaho?
Idaho 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
$650.15
1 of 1 localities have a supported rate.
Payment area: Idaho
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 53210: Total female urethral excision
Reports complete removal of the female urethra, including the associated cystostomy, for cases requiring excision beyond a biopsy or localized lesion procedure.
This service represents complete surgical removal of the female urethra, with cystostomy included in the procedure. It is generally performed by a urologist or other surgeon managing urethral disease in an operating room, such as for a malignancy requiring removal of the full urethra. It is more extensive than sampling tissue or removing a localized urethral lesion.
Select this code when the operative report supports total urethral removal in a female patient and the included cystostomy. The record should identify the extent of excision and the operative steps; a limited biopsy or lesion procedure does not support this service. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery billing is not allowed.
CMS billing rules for 53210
- 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 RVU13.38 · 64%
- Practice expense (office) RVU5.73 · 28%
- Malpractice RVU1.72 · 8%
74
Medicare services in 2024 · #5112 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.
53210 compared with similar codes
Office rates for Idaho, from the same CMS release.
$153.81
53200 is for biopsy and tissue sampling. Report this code when the operation removes the entire female urethra, not just a diagnostic specimen.
No office rate
53220 addresses treatment of a urethral lesion. This code represents complete urethral removal, a substantially broader operation.
No office rate
53230 is for removal of a urethral lesion. Use this code when the documented procedure removes the entire urethra rather than a localized lesion.
Compare 53210 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
Idaho →
Office / nonfacility
Unavailable
Facility
$650.15
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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 53210 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
6,180
- Code
- 53210
- Physician work
- 13.38
- Practice expense
- 5.73
- Malpractice
- 1.72
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.38 | × 1.000 | 13.3800 |
| Practice expense | 5.73 | × 0.920 | 5.2716 |
| Malpractice | 1.72 | × 0.473 | 0.8136 |
| Total RVUs | 19.4652 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$650.15
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.38 | 1 |
| Practice expense | 5.73 | 0.92 |
| Malpractice | 1.72 | 0.473 |
(13.38 × 1 + 5.73 × 0.92 + 1.72 × 0.473) × $33.4009 = $650.15
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.
53210 billing questions
How is this code distinguished from 53215?
53210 is for total urethral removal in a female patient; 53215 is the corresponding code for a male patient. Use the code matching the documented patient anatomy and procedure.
Can a urethral biopsy be reported instead?
Use 53200 when the service is a biopsy rather than complete removal. A biopsy does not support reporting total urethrectomy.
Does this code include the cystostomy?
Yes. The procedure includes the cystostomy, so do not separately report that component as though it were an independent service.
Can modifier 50 be used?
No. Modifier 50 is inappropriate for this anatomical service.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When may an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery billing is not allowed.
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.
6,17753080,,Drainage of urinary leakage,A,,6.75,4.04,NA,4.04,,0.87,11.66,11.66,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17853085,,Drainage of urinary leakage,A,,10.90,5.39,NA,5.39,,1.40,17.69,17.69,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17953200,,Biopsy of urethra,A,,2.53,2.06,,0.92,,0.38,4.97,3.83,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18053210,,Removal of urethra,A,,13.38,5.73,NA,5.73,,1.72,20.83,20.83,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18153215,,Removal of urethra,A,,16.43,6.37,NA,6.37,,2.13,24.93,24.93,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18253220,,Treatment of urethra lesion,A,,7.44,4.05,NA,4.05,,0.96,12.45,12.45,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18353230,,Removal of urethra lesion,A,,10.18,4.94,NA,4.94,,1.47,16.59,16.59,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772