Billing code 53500: UrethrolysisMedicare rate & RVUs in Illinois
Transvaginal urethrolysis frees the female urethra from scar tissue or tethering causing obstruction, often after prior anti-incontinence surgery.
CMS doesn’t publish an office rate for 53500 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 53500 covers
A urologist or urogynecologist uses a vaginal approach to release scar tissue or adhesions restricting the female urethra. A typical situation is persistent difficulty emptying the bladder from urethral tethering after prior anti-incontinence surgery. Endoscopic control may be used during the operation, but the code describes the transvaginal release whether or not it is used. This is an operative service, generally performed in a surgical setting, rather than an office treatment for urinary symptoms.
Report the code when the operative work frees the urethra from obstructing periurethral scar or fixation; document the cause of obstruction, relevant prior surgery, operative findings, and the release 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% multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be made; 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 53500 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 | $760.06 |
| East St. Louis | Unavailable | $723.28 |
| Rest Of Illinois | Unavailable | $692.92 |
| Suburban Chicago | Unavailable | $730.41 |
How the 53500 rate is calculated
Each of 53500’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 · 53500
RVUs × geographic indexes × conversion factor
Work12.68
12.68 RVUs× 1.000 GPCI
Practice expense5.53
5.53 RVUs× 1.000 GPCI
Malpractice1.93
1.93 RVUs× 1.000 GPCI
Adjusted RVUs
20.1400
Conversion factor
$33.4009
Medicare rate
$672.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53500
53500 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53500
Urethrolysis
| 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) | 0.12/0.74/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 53500
Urethrolysis
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
53500 without 51 · national facility
$672.69
Urethrolysis
53500-51 · Second procedure: 50%
$336.35
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%).
53500 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 57287Sling revision
- Use 57287 for removal or revision of a sling when that is the operative treatment. Urethrolysis frees the urethra from scar or tethering; both may be needed in selected cases.
- 53410Urethral reconstruction
- This code describes one-stage reconstruction of the female urethra. Choose 53500 when the work is release of periurethral scar, not reconstruction of the urethral channel.
- 53502Urethral repair
- This code is for urethral injury repair. Choose 53500 for transvaginal urethral release when the operative problem is scar-related restriction rather than an injury.
53500 billing questions
When should 53500 be chosen instead of a urethral repair code?
Use 53500 for transvaginal release of scar or tethering that restricts the urethra. A urethral repair code describes repair of an injury or defect, not release of external fixation.
Can 53500 be reported when endoscopic control is used?
Yes. Endoscopic control may be used as part of the transvaginal urethrolysis; its use does not change the selection of 53500.
Should modifier 50 be appended for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code and anatomy.
What supports reporting 53500?
Document the urethral obstruction or tethering, the relevant scar or prior operative history, and the transvaginal release performed. The note should make clear that the work freed the urethra rather than repaired a urethral injury.
How does the 90-day global affect postoperative visits?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the global surgical service.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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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