No office rate
51550 is for partial bladder excision without ureteral reimplantation. Choose 51565 when the operation also reimplants one or both ureters.
On this page
CMS RVU26D · Effective 2026-10-01
51565 Bladder surgery Medicare reimbursement rates in Kentucky
Reports partial bladder removal with reimplantation of one or both ureters into the remaining bladder, such as for a lesion involving a ureteral opening. Compare 51565 office and facility rates across CMS payment localities in Kentucky.
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 51565 in Kentucky?
Kentucky 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
$1111.42
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 51565: Partial bladder excision with ureteral reimplantation
Reports partial bladder removal with reimplantation of one or both ureters into the remaining bladder, such as for a lesion involving a ureteral opening.
This operation removes part of the bladder and relocates one or both ureteral openings into the bladder that remains. Urologists perform it when the excised bladder segment includes a ureteral insertion or when ureteral drainage must be restored after the bladder resection. A typical situation is selected bladder tumor surgery involving a ureteral orifice. The procedure is performed in an operating room under anesthesia.
Report this code when both partial bladder excision and ureteral reimplantation are performed; documentation should identify the bladder segment removed and the ureter or ureters reimplanted. Medicare treats it as major surgery with 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% 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 51565
- 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 RVU23.09 · 67%
- Practice expense (office) RVU8.40 · 24%
- Malpractice RVU2.97 · 9%
44
Medicare services in 2024 · #5437 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.
51565 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
51555 describes complicated partial bladder excision without ureteral reimplantation; 51565 includes reimplantation as part of the operation.
No office rate
50780 represents ureteral reimplantation without the partial bladder excision captured by 51565.
No office rate
51570 describes complete bladder removal. 51565 is for an operation that removes only part of the bladder and reimplants ureteral drainage.
Compare 51565 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$1111.42
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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 51565 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
6,033
- Code
- 51565
- Physician work
- 23.09
- Practice expense
- 8.40
- Malpractice
- 2.97
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 23.09 | × 1.000 | 23.0900 |
| Practice expense | 8.40 | × 0.889 | 7.4676 |
| Malpractice | 2.97 | × 0.915 | 2.7176 |
| Total RVUs | 33.2752 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$1111.42
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 23.09 | 1 |
| Practice expense | 8.4 | 0.889 |
| Malpractice | 2.97 | 0.915 |
(23.09 × 1 + 8.4 × 0.889 + 2.97 × 0.915) × $33.4009 = $1111.42
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.
51565 billing questions
When should I report this instead of 51550 or 51555?
Use 51565 when the partial bladder excision includes reimplantation of one or both ureters. Codes 51550 and 51555 describe partial bladder excision without that reimplantation.
Can the ureteral reimplantation be billed separately?
The reimplantation is part of the service represented by 51565. Do not separately report the same reimplantation as though it were an independent service.
Should modifier 50 be used when both ureters are reimplanted?
No. CMS identifies bilateral adjustment as inappropriate for this code, including when the operative work involves both ureters.
What documentation supports reporting 51565?
The operative report should describe the partial bladder resection and identify the ureter or ureters reimplanted into the remaining bladder.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the global surgery payment.
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.
6,03051535,,Repair of ureter lesion,A,,13.55,5.80,NA,5.80,,1.74,21.09,21.09,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,03151550,,Partial removal of bladder,A,,16.80,6.80,NA,6.80,,2.49,26.09,26.09,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,03251555,,Partial removal of bladder,A,,22.60,8.10,NA,8.10,,3.11,33.81,33.81,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,03351565,,Revise bladder & ureter(s),A,,23.09,8.40,NA,8.40,,2.97,34.46,34.46,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,03451570,,Removal of bladder,A,,26.77,8.83,NA,8.83,,3.45,39.05,39.05,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,03551575,,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
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
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631