No office rate
Choose 53431 when the female urethral reconstruction also includes bladder neck reconstruction. Use 53430 for reconstruction of the female urethra without that additional bladder neck work.
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CMS RVU26D · Effective 2026-10-01
53430 Urethral repair Medicare reimbursement rates in Kansas
Reconstructive surgery on the female urethra, reported for a repair that rebuilds the urethral channel rather than a limited revision. Compare 53430 office and facility rates across CMS payment localities in Kansas.
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 53430 in Kansas?
Kansas 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
$811.16
1 of 1 localities have a supported rate.
Payment area: Kansas
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.
Urology surgery
About 53430: Female urethral reconstruction
Reconstructive surgery on the female urethra, reported for a repair that rebuilds the urethral channel rather than a limited revision.
This operation rebuilds the female urethra to restore a usable channel, such as when a stricture or structural defect requires reconstructive repair. A urologist or female pelvic medicine and reconstructive surgeon typically performs it in an operating room, using an approach suited to the location and extent of the urethral problem. The operative report should identify the defect and describe the reconstruction performed.
Report this code for female urethral reconstruction; use a neighboring code when the operative work instead includes bladder neck reconstruction or addresses a different urethral anatomy or procedure. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed 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 single urethral reconstruction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 53430
- 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 RVU16.99 · 65%
- Practice expense (office) RVU6.71 · 26%
- Malpractice RVU2.44 · 9%
213
Medicare services in 2024 · #4267 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.
53430 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
53410 describes one-stage reconstruction of the male anterior urethra; 53430 is for female urethral reconstruction.
No office rate
53415 addresses one-stage reconstruction of the male prostatic or membranous urethra, rather than reconstruction of the female urethra.
53450
No office rateUrethral revision
53450 is for revision of the urethra. Choose 53430 when the operative work is reconstructive rebuilding of the female urethra rather than a revision procedure.
Compare 53430 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
Kansas →
Office / nonfacility
Unavailable
Facility
$811.16
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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 53430 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
6,197
- Code
- 53430
- Physician work
- 16.99
- Practice expense
- 6.71
- Malpractice
- 2.44
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 16.99 | × 1.000 | 16.9900 |
| Practice expense | 6.71 | × 0.904 | 6.0658 |
| Malpractice | 2.44 | × 0.504 | 1.2298 |
| Total RVUs | 24.2856 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$811.16
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 16.99 | 1 |
| Practice expense | 6.71 | 0.904 |
| Malpractice | 2.44 | 0.504 |
(16.99 × 1 + 6.71 × 0.904 + 2.44 × 0.504) × $33.4009 = $811.16
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.
53430 billing questions
When is 53431 used instead?
Use 53431 when the operation reconstructs the female urethra and also reconstructs the bladder neck. The operative report should support that additional bladder neck work.
How does 53430 differ from male urethroplasty codes?
53430 is for reconstruction of the female urethra. Codes such as 53410 and 53415 describe reconstruction involving male urethral anatomy.
Can modifier 50 be appended?
No. Modifier 50 is inappropriate for this reconstruction of the female urethra.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
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.
6,19453415,,Reconstruction of urethra,A,,20.18,7.49,NA,7.49,,2.61,30.28,30.28,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19553420,,Reconstruct urethra stage 1,A,,14.79,5.98,NA,5.98,,1.91,22.68,22.68,0,090,0.08,0.83,0.09,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19653425,,Reconstruct urethra stage 2,A,,16.64,6.36,NA,6.36,,2.14,25.14,25.14,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19753430,,Reconstruction of urethra,A,,16.99,6.71,NA,6.71,,2.44,26.14,26.14,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19853431,,Reconstruct urethra/bladder,A,,20.65,7.55,NA,7.55,,2.65,30.85,30.85,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,19953440,,Male sling procedure,A,,13.03,5.70,NA,5.70,,1.67,20.40,20.40,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20053442,,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
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958