No office rate
Choose 51595 when bilateral pelvic lymphadenectomy accompanies complete cystectomy and cutaneous urinary diversion; 51590 describes the diversion operation without that node dissection.
On this page
CMS RVU26D · Effective 2026-10-01
51590 Bladder removal Medicare reimbursement rates in Iowa
Reports complete bladder removal with urinary drainage redirected to the skin through a ureterostomy or an ileal conduit, commonly during bladder cancer surgery. Compare 51590 office and facility rates across CMS payment localities in Iowa.
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 51590 in Iowa?
Iowa 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
$1585.36
1 of 1 localities have a supported rate.
Payment area: Iowa
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 51590: Complete cystectomy with cutaneous urinary diversion
Reports complete bladder removal with urinary drainage redirected to the skin through a ureterostomy or an ileal conduit, commonly during bladder cancer surgery.
A urologist removes the entire bladder and creates a route for urine to reach a stoma on the abdominal skin. The diversion may bring the ureters directly to the skin or connect them to a segment of ileum that functions as a conduit. This operation is commonly performed in a hospital for bladder cancer requiring cystectomy; the patient collects urine in an external ostomy appliance.
Select this code when the operative service includes complete cystectomy and one of these cutaneous diversions, without the bilateral pelvic lymphadenectomy represented by a related code. The operative report should establish the extent of bladder removal, the diversion method, and whether bilateral pelvic nodes were removed. The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period. 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. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 51590
- 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 RVU35.42 · 69%
- Practice expense (office) RVU11.12 · 22%
- Malpractice RVU4.71 · 9%
609
Medicare services in 2024 · #3381 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.
51590 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
51580 uses a sigmoid-based urinary diversion. This code describes a cutaneous ureterostomy or ureteroileostomy.
No office rate
51596 is for a continent urinary diversion. Choose 51590 for a cutaneous diversion that drains to an external ostomy appliance.
No office rate
51570 reports complete cystectomy without the cutaneous urinary diversion included in 51590.
Compare 51590 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
Iowa →
Office / nonfacility
Unavailable
Facility
$1585.36
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 51590 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
6,038
- Code
- 51590
- Physician work
- 35.42
- Practice expense
- 11.12
- Malpractice
- 4.71
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 35.42 | × 1.000 | 35.4200 |
| Practice expense | 11.12 | × 0.915 | 10.1748 |
| Malpractice | 4.71 | × 0.397 | 1.8699 |
| Total RVUs | 47.4647 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$1585.36
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 35.42 | 1 |
| Practice expense | 11.12 | 0.915 |
| Malpractice | 4.71 | 0.397 |
(35.42 × 1 + 11.12 × 0.915 + 4.71 × 0.397) × $33.4009 = $1585.36
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.
51590 billing questions
How does this code differ from 51595?
51590 describes complete cystectomy with a cutaneous ureterostomy or ureteroileostomy. Use 51595 when the operation also includes bilateral pelvic lymphadenectomy.
Is creation of the urinary diversion included?
Yes. The code represents the cystectomy with the specified cutaneous diversion, whether the ureters reach the skin directly or through an ileal conduit.
Can modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code; the operative anatomy and service are not reported with modifier 50.
What supports reporting 51590 rather than another cystectomy code?
The operative report should document complete bladder removal and whether urine was diverted by cutaneous ureterostomy or ureteroileostomy. It should also clarify whether bilateral pelvic lymphadenectomy was performed.
How are assistant and co-surgeon services handled?
An assistant at surgery may be paid. 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.
6,03551575,,Removal of bladder & nodes,A,,33.33,10.57,NA,10.57,,4.28,48.18,48.18,0,090,0.08,0.83,0.09,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,03651580,,Remove bladder/revise tract,A,,34.49,11.47,NA,11.47,,4.44,50.40,50.40,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,03751585,,Removal of bladder & nodes,A,,38.65,12.33,NA,12.33,,4.96,55.94,55.94,0,090,0.08,0.83,0.09,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,03851590,,Remove bladder/revise tract,A,,35.42,11.12,NA,11.12,,4.71,51.25,51.25,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,03951595,,Remove bladder/revise tract,A,,40.29,12.35,NA,12.35,,5.29,57.93,57.93,0,090,0.08,0.83,0.09,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,04051596,,Remove bladder/create pouch,A,,43.15,13.68,NA,13.68,,5.69,62.52,62.52,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,04151597,,Removal of pelvic structures,A,,41.79,13.56,NA,13.56,,5.73,61.08,61.08,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136