No office rate
This code concerns one-stage reconstruction of the male anterior urethra. Code 53415 is for one-stage reconstruction involving the prostatic or membranous urethra.
On this page
CMS RVU26D · Effective 2026-10-01
53410 Urethral reconstruction Medicare reimbursement rates in Illinois
Reports a single-stage reconstructive operation on the male anterior urethra, such as repair of a urethral stricture or defect. Compare 53410 office and facility rates across CMS payment localities in Illinois.
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 53410 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$901.23–$980.65
4 of 4 localities have a supported rate.
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.
Where 53410 pays more and less in Illinois
Urology surgery
About 53410: One-stage male anterior urethral reconstruction
Reports a single-stage reconstructive operation on the male anterior urethra, such as repair of a urethral stricture or defect.
A urologist uses this code for one-stage reconstruction of the male anterior urethra, commonly to restore the channel affected by a stricture or tissue defect. The operation may use local tissue or a graft to rebuild the narrowed or damaged segment. These procedures are generally performed in a surgical facility, with the operative report identifying the urethral site and reconstructive approach.
Select this code when the surgeon completes the anterior urethral reconstruction in one stage; a planned two-stage reconstruction follows the applicable stage-specific codes instead. Documentation should establish the anatomy treated, the reason for reconstruction, and the technique and extent of the repair. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 53410
- 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 RVU17.24 · 65%
- Practice expense (office) RVU6.87 · 26%
- Malpractice RVU2.22 · 8%
781
Medicare services in 2024 · #3177 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.
53410 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
Code 53420 represents the first stage of a planned two-stage male anterior urethral reconstruction; this code is for reconstruction completed in one stage.
No office rate
Code 53425 represents the second stage of a planned two-stage male anterior urethral reconstruction, rather than a one-stage repair.
No office rate
Code 53430 is for female urethral reconstruction. This code is specific to the male anterior urethra.
Compare 53410 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$980.65
East St. Louis →
Office / nonfacility
Unavailable
Facility
$936.28
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$901.23
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$946.92
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53410 billing questions
How is this distinguished from a two-stage anterior urethral reconstruction?
Use this code when the reconstruction is completed in one stage. For a planned two-stage reconstruction, report the applicable first- or second-stage code.
What operative details support reporting this code?
The report should identify the male anterior urethral segment treated, the stricture or defect being repaired, and the reconstructive method and extent.
Are related postoperative visits separately reported?
Related postoperative care during the 90-day global period is included. The global period also includes the day-before preoperative visit.
Can modifier 50 be used for bilateral reconstruction?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used to represent bilateral work.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. Assistant-at-surgery payment may be made; co-surgeon claims need supporting documentation.
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.
6,19053275,,Repair of urethra defect,A,,4.46,2.06,NA,2.06,,0.62,7.14,7.14,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19153400,,Revise urethra stage 1,A,,13.78,6.06,NA,6.06,,1.83,21.67,21.67,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19253405,,Revise urethra stage 2,A,,15.27,6.34,NA,6.34,,1.96,23.57,23.57,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19353410,,Reconstruction of urethra,A,,17.24,6.87,NA,6.87,,2.22,26.33,26.33,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19453415,,Reconstruction of urethra,A,,20.18,7.49,NA,7.49,,2.61,30.28,30.28,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19553420,,Reconstruct urethra stage 1,A,,14.79,5.98,NA,5.98,,1.91,22.68,22.68,0,090,0.08,0.83,0.09,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19653425,,Reconstruct urethra stage 2,A,,16.64,6.36,NA,6.36,,2.14,25.14,25.14,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00