No office rate
51860 is for a simple bladder-wound suture repair; 51865 is for a complicated repair. Let the documented repair and operative findings support the level.
On this page
CMS RVU26D · Effective 2026-10-01
51860 Bladder repair Medicare reimbursement rates in Missouri
Reports straightforward suture repair of a bladder wound, such as an injury encountered during pelvic or abdominal surgery. Compare 51860 office and facility rates across CMS payment localities in Missouri.
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 51860 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$652.02–$672.34
3 of 3 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.
Where 51860 pays more and less in Missouri
Urology surgery
About 51860: Simple bladder injury suture repair
Reports straightforward suture repair of a bladder wound, such as an injury encountered during pelvic or abdominal surgery.
CPT 51860 describes a straightforward surgical suture repair of a bladder wound. It may be performed by a urologist or by the surgeon who identifies a bladder injury during an operation, including pelvic or abdominal surgery. The service is generally provided in an operating room; the operative report should identify the wound and describe the repair performed. This code is for a simple repair, not a more involved bladder-wound repair or closure of a planned cystostomy opening.
Select the code based on the documented nature and complexity of the repair; use 51865 when the repair meets the complicated level. The 90-day global period includes 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 multiple-procedure reduction. Modifier 50 is not appropriate for this repair. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 51860
- 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 RVU12.29 · 60%
- Practice expense (office) RVU6.14 · 30%
- Malpractice RVU1.99 · 10%
969
Medicare services in 2024 · #2996 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.
51860 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
51880 describes closing a cystostomy opening. Use 51860 for a bladder wound, such as an injury repaired with sutures.
No office rate
51820 is for vesicovaginal fistula repair. A bladder wound injury repaired with sutures is the situation addressed by 51860.
Compare 51860 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$668.01
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$672.34
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$652.02
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51860 billing questions
How do I choose between 51860 and 51865?
Use 51860 for a simple bladder-wound suture repair. Use 51865 when the operative documentation supports a complicated repair.
Can 51860 be reported when a bladder injury is repaired during another operation?
It may be reported for the bladder-wound repair when performed with another procedure. The standard multiple-procedure reduction applies when procedures are performed in the same session.
Should modifier 50 be appended for a bladder wound on both sides?
No. The bladder repair is not reported with modifier 50.
What documentation supports reporting 51860?
The operative report should identify the bladder wound and describe the suture repair and its level of complexity, supporting selection of the simple repair code rather than 51865.
Can an assistant surgeon be paid for this procedure?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Does 51860 include related postoperative care?
Yes. Its 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
6,09051840,,Attach bladder/urethra,A,,11.08,5.92,NA,5.92,,1.63,18.63,18.63,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,09151841,,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