Billing code 53665: Urethral dilationMedicare rate & RVUs in Illinois
Reports complicated urethral dilation in a female patient when the procedure involves circumstances beyond routine female urethral dilation.
CMS doesn’t publish an office rate for 53665 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 53665 covers
A urologist or other qualified clinician uses urethral dilators to widen a narrowed female urethra when the dilation is complicated. The service may be performed in an office or facility setting. The record should explain the urethral problem and the circumstances that make the dilation complicated; the code is not selected simply because dilation is repeated.
Report 53665 for the complicated female procedure rather than routine female dilation, distinguishing it from initial and subsequent services in that code family. Document the indication, relevant anatomy or history, and work performed. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are 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 53665 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 | $37.16 |
| East St. Louis | Unavailable | $35.69 |
| Rest Of Illinois | Unavailable | $34.29 |
| Suburban Chicago | Unavailable | $35.70 |
How the 53665 rate is calculated
Each of 53665’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 · 53665
RVUs × geographic indexes × conversion factor
Work0.74
0.74 RVUs× 1.000 GPCI
Practice expense0.16
0.16 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
0.9900
Conversion factor
$33.4009
Medicare rate
$33.07
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53665
The CMS indicators that decide how 53665 is paid alongside other services.
CMS payment indicators · 53665
Urethral dilation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
53665 without 51 · national facility
$33.07
Urethral dilation
53665-51 · Second procedure: 50%
$16.54
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%).
53665 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 53660Urethral dilation
- This code describes routine initial female urethral dilation; 53665 is for a complicated female dilation.
- 53661Urethral dilation
- This code describes routine subsequent female urethral dilation; 53665 is selected for a complicated procedure, not merely because it is repeated.
- 53605Urethral dilation
- Both describe complicated dilation, but 53605 is for a male patient and 53665 is for a female patient.
53665 billing questions
When should 53665 be selected instead of 53660 or 53661?
Use 53665 for complicated female urethral dilation. Codes 53660 and 53661 distinguish routine female dilation by initial versus subsequent service.
Does a repeat dilation qualify as complicated?
Not by itself. The documentation should describe the circumstances that make the procedure complicated, rather than relying only on the fact that dilation was performed before.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's global period.
Can an assistant or co-surgeon be billed for 53665?
Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are 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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