No office rate
Use 51860 for simple bladder-wound closure. Use 51865 when the operative record supports a complicated repair.
On this page
CMS RVU26D · Effective 2026-10-01
51865 Bladder wound repair Medicare reimbursement rates in Michigan
Report complicated surgical closure of a bladder wound, such as a bladder injury requiring more involved repair than a simple wound closure. Compare 51865 office and facility rates across CMS payment localities in Michigan.
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 51865 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$800.23–$852.86
2 of 2 localities have a supported rate.
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 51865: Complicated bladder wound repair
Report complicated surgical closure of a bladder wound, such as a bladder injury requiring more involved repair than a simple wound closure.
This service covers surgical repair of a complicated bladder wound, including a bladder laceration or an injury encountered during another operation. A urologist or other surgeon typically performs the repair in an operating room, often during surgery for abdominal or pelvic trauma or a procedure that has injured the bladder. The operative record should identify the wound and explain the work that makes the repair complicated.
Choose this code when the documented repair is complicated rather than a simple bladder-wound closure; the operative approach or setting alone does not establish that distinction. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 for this bladder repair. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery billing is not permitted.
CMS billing rules for 51865
- 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 RVU15.41 · 64%
- Practice expense (office) RVU6.63 · 27%
- Malpractice RVU2.21 · 9%
584
Medicare services in 2024 · #3419 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.
51865 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
51880 addresses closure of a cystostomy tract. 51865 repairs a bladder wound, such as an injury.
No office rate
51800 is for reconstructive bladder-urethral surgery; 51865 is for repair of a complicated bladder wound.
Compare 51865 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
Unavailable
Facility
$852.86
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$800.23
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51865 billing questions
How is 51865 distinguished from 51860?
51865 is for a complicated bladder-wound repair; 51860 is for a simple repair. The operative documentation should support the complexity of the work rather than relying on the procedure setting alone.
Can modifier 50 be used for repair of wounds on both sides of the bladder?
No. Modifier 50 is inappropriate for this service; the CMS bilateral adjustment does not apply to this bladder repair.
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?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team-surgery billing is not permitted.
How is 51865 paid when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.
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.
6,09151841,,Attach bladder/urethra,A,,13.34,6.46,NA,6.46,,1.71,21.51,21.51,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09251845,,Repair bladder neck,A,,9.90,4.70,NA,4.70,,1.28,15.88,15.88,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09351860,,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