No office rate
Both codes address vesicovaginal fistula closure. Choose 51900 for the vaginal route and 51925 for the abdominal route, with or without hysterectomy.
On this page
CMS RVU26D · Effective 2026-10-01
51900 Fistula repair Medicare reimbursement rates in Indiana
Reports vaginal-route surgical closure of a communication between the bladder and vagina, commonly performed for persistent urinary leakage through the vagina. Compare 51900 office and facility rates across CMS payment localities in Indiana.
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 51900 in Indiana?
Indiana has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$698.59
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
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.
Urologic surgery
About 51900: Vaginal closure of bladder-vaginal fistula
Reports vaginal-route surgical closure of a communication between the bladder and vagina, commonly performed for persistent urinary leakage through the vagina.
This operation closes a vesicovaginal fistula through the vagina. The surgeon identifies and separates the bladder and vaginal sides of the abnormal opening, then closes the defect. It is commonly performed by a urologist, urogynecologist, or gynecologic surgeon when a patient has ongoing urine leakage into the vagina, often after pelvic surgery or an obstetric injury. The service is generally performed in an operating room rather than an office setting.
Report 51900 when the documented fistula is between the bladder and vagina and the repair uses the vaginal route. The operative report should support the fistula location, the approach, and the closure performed; an uncomplicated vaginal injury without a bladder fistula is a different service. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. 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. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 51900
- 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 RVU14.26 · 64%
- Practice expense (office) RVU6.22 · 28%
- Malpractice RVU1.83 · 8%
32
Medicare services in 2024 · #5626 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.
51900 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
This code concerns a fistula between the bladder and uterus. Code 51900 is for a bladder-to-vagina communication.
No office rate
This code is for repair of a nonobstetrical vaginal injury. Use 51900 when the operation closes a vesicovaginal fistula, not an isolated vaginal injury.
Compare 51900 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.
1 of 1 payment localities
Indiana →
Office / nonfacility
Unavailable
Facility
$698.59
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 51900 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
6,096
- Code
- 51900
- Physician work
- 14.26
- Practice expense
- 6.22
- Malpractice
- 1.83
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.26 | × 1.000 | 14.2600 |
| Practice expense | 6.22 | × 0.927 | 5.7659 |
| Malpractice | 1.83 | × 0.486 | 0.8894 |
| Total RVUs | 20.9153 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$698.59
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.26 | 1 |
| Practice expense | 6.22 | 0.927 |
| Malpractice | 1.83 | 0.486 |
(14.26 × 1 + 6.22 × 0.927 + 1.83 × 0.486) × $33.4009 = $698.59
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
51900 billing questions
When should 51900 be selected instead of 51925?
Use 51900 for closure of a vesicovaginal fistula through the vaginal route. Code 51925 describes the abdominal approach and includes the possibility of hysterectomy.
Is a vaginal laceration repair reported with 51900?
Not when there is no communication between the bladder and vagina. A nonobstetrical vaginal injury repair is a different service; the operative findings should establish whether a fistula was repaired.
Can modifier 50 be used for a fistula on each side?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care. Separate procedures during the same session are subject to the standard multiple-procedure reduction.
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 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.
6,09351860,,Repair of bladder wound,A,,12.29,6.14,NA,6.14,,1.99,20.42,20.42,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09451865,,Repair of bladder wound,A,,15.41,6.63,NA,6.63,,2.21,24.25,24.25,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09551880,,Repair of bladder opening,A,,7.67,4.08,NA,4.08,,1.11,12.86,12.86,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09651900,,Repair bladder/vagina lesion,A,,14.26,6.22,NA,6.22,,1.83,22.31,22.31,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09751920,,Close bladder-uterus fistula,A,,13.07,5.99,NA,5.99,,1.68,20.74,20.74,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09851925,,Hysterectomy/bladder repair,A,,17.09,8.22,NA,8.22,,3.00,28.31,28.31,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09951940,,Correction of bladder defect,A,,29.89,9.88,NA,9.88,,3.85,43.62,43.62,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915