Billing code 51525: Bladder surgeryMedicare rate & RVUs in Illinois
Reports open removal of one or more bladder diverticula through a bladder incision, typically for symptomatic diverticula requiring surgical excision.
CMS doesn’t publish an office rate for 51525 in Illinois.
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 51525 covers
A urologist performs this operation through an incision into the bladder to remove one or more diverticula. It is generally done in an operating room when a diverticulum is causing problems such as urinary stasis, recurrent infection, stones, or obstruction, or otherwise warrants surgical treatment. The operative report should establish that the target was a bladder diverticulum and describe its removal; this is not the code for excising a bladder tumor.
Select this code for diverticulectomy through cystotomy, whether one or multiple diverticula are removed. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 multiple-procedure reduction. Modifier 50 is inappropriate for this bladder procedure. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery 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 51525 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $864.28 |
| East St. Louis | Unavailable | $824.61 |
| Rest Of Illinois | Unavailable | $793.06 |
| Suburban Chicago | Unavailable | $833.84 |
How the 51525 rate is calculated
Each of 51525’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 · 51525
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 15.03Practice expense 6.12Malpractice 2.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 51525
51525 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 51525
Bladder surgery
| 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 · 51525
Bladder surgery
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
51525 without 51 · national facility
$773.23
Bladder surgery
51525-51 · Second procedure: 50%
$386.62
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%).
51525 compared with similar codes
Compare codes
51525 vs 51520 vs 51530 vs 51550: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 51520Bladder diverticulectomy
- Use 51525 for diverticulum excision. Code 51520 is for a bladder tumor procedure involving fulguration or resection.
- 51530Bladder tumor excision
- Use 51525 when the structure removed is a diverticulum; 51530 describes excision of bladder tumor or tumors.
- 51550Partial cystectomy
- Use 51525 for excision of bladder diverticula. Code 51550 is for partial removal of the bladder, a broader resection.
51525 billing questions
When should I report this instead of a bladder tumor excision code?
Report 51525 when the surgeon removes a bladder diverticulum through cystotomy. Codes 51520 and 51530 address bladder tumor procedures, not diverticulectomy.
Does the code cover removal of more than one diverticulum?
Yes. The code covers excision of a single diverticulum or multiple diverticula during the operation.
What documentation supports 51525?
The operative report should identify the bladder diverticulum or diverticula, document the cystotomy approach and excision, and distinguish the target from a bladder tumor.
Should modifier 50 be appended for diverticula on both sides?
No. The bladder is a single organ for this service, and modifier 50 is inappropriate.
How are other procedures performed in the same session handled?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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 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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