No office rate
53445 reports placement of an inflatable urinary sphincter. Use 53446 for removal of an existing system without replacement.
On this page
CMS RVU26D · Effective 2026-10-01
53446 Sphincter removal Medicare reimbursement rates in Illinois
Reports surgical removal of an implanted artificial urinary sphincter, such as for device infection, erosion, or failure, without replacement during the procedure. Compare 53446 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 53446 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
$597.06–$649.87
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 53446 pays more and less in Illinois
Urology surgery
About 53446: Removal of artificial urinary sphincter
Reports surgical removal of an implanted artificial urinary sphincter, such as for device infection, erosion, or failure, without replacement during the procedure.
A urologist removes an implanted inflatable urinary sphincter used to manage incontinence, commonly after prostate surgery. The device includes components such as a urethral cuff, pump, and fluid reservoir. Removal may be needed when the system is infected, eroded, malfunctioning, or otherwise requires explantation. This is generally performed in a facility operating room rather than an office setting.
Report this code when the documented operation removes the sphincter system without replacing it. The operative report should identify the device and describe the components removed and the reason for removal; use a removal-and-replacement code when a new system or components are implanted during the procedure. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 53446
- 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 RVU10.74 · 61%
- Practice expense (office) RVU5.47 · 31%
- Malpractice RVU1.37 · 8%
734
Medicare services in 2024 · #3220 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.
53446 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
53447 includes removal and replacement of the sphincter system. Use 53446 when no replacement is performed.
No office rate
53448 describes removal and replacement of sphincter components. This code is for removal without component replacement.
No office rate
53449 describes repair of a urinary sphincter. Choose 53446 when the operation removes the device instead of repairing it.
Compare 53446 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
$649.87
East St. Louis →
Office / nonfacility
Unavailable
Facility
$618.97
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$597.06
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$629.96
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53446 billing questions
When should this code be used instead of 53447?
Use 53446 when the implanted sphincter is removed without replacement. Code 53447 describes removal and replacement of the sphincter system.
How does this differ from 53448?
53448 is for removal and replacement of sphincter components. This code describes removal without replacement.
Can removal and a new sphincter insertion be reported separately?
When a sphincter is removed and replaced during the same procedure, use the applicable removal-and-replacement code rather than reporting removal and insertion separately.
What documentation supports reporting this code?
The operative report should identify the artificial urinary sphincter, document the removal performed, and state the reason for explantation, such as infection, erosion, or device failure.
Can modifier 50 be used for bilateral removal?
No. Modifier 50 is inappropriate for this code based on the descriptor or anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
6,20053442,,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
6,20453447,,Remove/replace ur sphincter,A,,13.92,6.18,NA,6.18,,1.78,21.88,21.88,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20553448,,Remov/replc ur sphinctr comp,A,,22.85,8.43,NA,8.43,,2.94,34.22,34.22,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20653449,,Repair uro sphincter,A,,10.30,5.12,NA,5.12,,1.33,16.75,16.75,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00