No office rate
This code is for total urethral removal in a male. Code 53210 is the corresponding total-removal code for a female patient.
On this page
CMS RVU26D · Effective 2026-10-01
53215 Urethrectomy Medicare reimbursement rates in Nebraska
This service covers complete removal of the male urethra with cystostomy, typically performed by a urologist when definitive treatment requires removal of the entire urethra. Compare 53215 office and facility rates across CMS payment localities in Nebraska.
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 53215 in Nebraska?
Nebraska 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
$772.05
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 53215: Total urethral removal in a male
This service covers complete removal of the male urethra with cystostomy, typically performed by a urologist when definitive treatment requires removal of the entire urethra.
A urologist performs this major operation to remove the entire urethra in a male patient; the procedure includes cystostomy. A typical clinical setting is hospital surgery for a disease, such as urethral cancer, that requires complete rather than localized urethral removal. The code represents removal of the whole urethra, not biopsy or treatment of a limited urethral lesion.
Report the code when the operative documentation supports total urethral removal in a male and the included cystostomy. CMS assigns a 90-day global period, which 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 inappropriate for this code. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 53215
- 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 RVU16.43 · 66%
- Practice expense (office) RVU6.37 · 26%
- Malpractice RVU2.13 · 9%
173
Medicare services in 2024 · #4458 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.
53215 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
Code 53215 is for removal of the entire male urethra; code 53230 concerns removal of a urethral lesion, not the whole urethra.
$152.81
Code 53200 is for obtaining a urethral biopsy specimen. Code 53215 represents definitive removal of the entire male urethra.
Compare 53215 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$772.05
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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 53215 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
6,181
- Code
- 53215
- Physician work
- 16.43
- Practice expense
- 6.37
- Malpractice
- 2.13
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 16.43 | × 1.000 | 16.4300 |
| Practice expense | 6.37 | × 0.923 | 5.8795 |
| Malpractice | 2.13 | × 0.378 | 0.8051 |
| Total RVUs | 23.1147 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$772.05
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 16.43 | 1 |
| Practice expense | 6.37 | 0.923 |
| Malpractice | 2.13 | 0.378 |
(16.43 × 1 + 6.37 × 0.923 + 2.13 × 0.378) × $33.4009 = $772.05
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.
53215 billing questions
How does this differ from code 53210?
Code 53215 describes total urethral removal in a male. Code 53210 is the corresponding total-removal code for a female patient.
Can this code be used for removal of only a urethral lesion?
No. This code represents removal of the entire male urethra. A code for treatment or removal of a localized urethral lesion is more appropriate when the operation is limited to that lesion.
Is cystostomy included in the service?
Yes. Cystostomy is included in the service described by this code; the operative report should support the total urethral removal and the included procedure.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included in the global period?
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.
6,17853085,,Drainage of urinary leakage,A,,10.90,5.39,NA,5.39,,1.40,17.69,17.69,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17953200,,Biopsy of urethra,A,,2.53,2.06,,0.92,,0.38,4.97,3.83,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18053210,,Removal of urethra,A,,13.38,5.73,NA,5.73,,1.72,20.83,20.83,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18153215,,Removal of urethra,A,,16.43,6.37,NA,6.37,,2.13,24.93,24.93,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18253220,,Treatment of urethra lesion,A,,7.44,4.05,NA,4.05,,0.96,12.45,12.45,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18353230,,Removal of urethra lesion,A,,10.18,4.94,NA,4.94,,1.47,16.59,16.59,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18453235,,Removal of urethra lesion,A,,10.72,5.21,NA,5.21,,1.36,17.29,17.29,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068