No office rate
Use 53446 when the urinary sphincter is removed without replacement. Use 53448 when the documented service includes component replacement.
On this page
CMS RVU26D · Effective 2026-10-01
53448 Sphincter replacement Medicare reimbursement rates in New Jersey
Reports removal and replacement of urinary sphincter components, typically during operative management of a malfunctioning or otherwise unsuitable artificial urinary sphincter. Compare 53448 office and facility rates across CMS payment localities in New Jersey.
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 53448 in New Jersey?
New Jersey 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
$1208.94–$1242.79
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 53448: Urinary sphincter component removal and replacement
Reports removal and replacement of urinary sphincter components, typically during operative management of a malfunctioning or otherwise unsuitable artificial urinary sphincter.
This operation involves removing and replacing urinary sphincter components, generally as revision of an implanted artificial urinary sphincter system. Urologists commonly perform it in a hospital or ambulatory surgery center for a patient whose implanted device requires operative replacement. The operative report should identify the components removed and implanted and describe the reason for the procedure, such as device malfunction or a change in the patient’s clinical condition.
Choose this code when the documented work matches its component removal-and-replacement service; distinguish it from removal alone, initial insertion, and repair without component replacement. The service has 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 50% reduction. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 53448
- 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 RVU22.85 · 67%
- Practice expense (office) RVU8.43 · 25%
- Malpractice RVU2.94 · 9%
55
Medicare services in 2024 · #5305 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.
53448 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
Code 53445 is for initial insertion of an inflatable urinary sphincter system; 53448 concerns removal and replacement of components in an existing system.
No office rate
Both codes address urinary sphincter removal and replacement. Determine the appropriate code from the exact component work and procedure documented.
No office rate
Code 53449 describes sphincter repair. It is not the component replacement service reported with 53448.
Compare 53448 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
Northern Nj →
Office / nonfacility
Unavailable
Facility
$1242.79
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$1208.94
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53448 billing questions
How does this differ from 53446?
Code 53446 is for removal of the urinary sphincter without replacement. Use 53448 when the operative report supports removal and replacement of the components described by this service.
How does this differ from 53445?
Code 53445 describes initial insertion of an inflatable urinary sphincter system. This code describes removal and replacement of components of an existing system.
How should this be distinguished from 53447?
Both codes concern urinary sphincter removal and replacement. Select based on the exact service and component work documented in the operative report, rather than treating the codes as interchangeable.
Are related postoperative visits included?
Yes. 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.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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.
6,20253445,,Insert uro/ves nck sphincter,A,,12.68,6.33,NA,6.33,,1.63,20.64,20.64,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20353446,,Remove uro sphincter,A,,10.74,5.47,NA,5.47,,1.37,17.58,17.58,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20453447,,Remove/replace ur sphincter,A,,13.92,6.18,NA,6.18,,1.78,21.88,21.88,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20553448,,Remov/replc ur sphinctr comp,A,,22.85,8.43,NA,8.43,,2.94,34.22,34.22,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20653449,,Repair uro sphincter,A,,10.30,5.12,NA,5.12,,1.33,16.75,16.75,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20753450,,Revision of urethra,A,,6.60,3.89,NA,3.89,,0.86,11.35,11.35,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,20853451,,Tprnl balo cntnc dev bi,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,010,0.10,0.80,0.10,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00