No office rate
57230 is directed at repair of a urethral lesion; 57220 is for revision or reconstruction of urethral anatomy.
On this page
CMS RVU26D · Effective 2026-10-01
57220 Urethral revision Medicare reimbursement rates in New Jersey
Surgical revision of urethral anatomy is reported when the operation revises the urethra rather than repairing a discrete lesion or vaginal support defect. Compare 57220 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 57220 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
$332.22–$343.68
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 57220: Urethral reconstructive revision
Surgical revision of urethral anatomy is reported when the operation revises the urethra rather than repairing a discrete lesion or vaginal support defect.
This code represents an operation that revises or reconstructs urethral anatomy. It is generally performed by a urologist or urogynecologist in an operating-room setting when the documented procedure is urethral revision, rather than treatment limited to a discrete urethral lesion or repair of an adjacent vaginal support defect. The operative report should identify the urethral structures addressed and the reconstructive work performed.
Report the code based on the procedure documented, not simply on a diagnosis involving urinary symptoms or prior surgery. The day-before preoperative visit and 90 days of related postoperative care are included in its major-surgery global period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% 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 57220
- 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 RVU4.73 · 51%
- Practice expense (office) RVU3.79 · 41%
- Malpractice RVU0.81 · 9%
377
Medicare services in 2024 · #3785 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.
57220 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
57240 addresses an anterior vaginal wall support defect, with or without urethrocele repair, rather than urethral revision itself.
No office rate
Use 57287 when the surgery revises or removes a sling; use 57220 when the documented work revises the urethra.
Compare 57220 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
$343.68
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$332.22
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
57220 billing questions
Is urethral revision the same as anterior colporrhaphy?
No. This code represents urethral revision; 57240 describes repair of an anterior vaginal wall support defect, with or without urethrocele repair.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What postoperative care is included?
The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid 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.
6,45057180,,Treat vaginal bleeding,A,,1.59,3.80,,1.34,,0.27,5.66,3.20,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45157200,,Repair of vagina,A,,4.31,4.01,NA,4.01,,0.80,9.12,9.12,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45257210,,Repair vagina/perineum,A,,5.57,4.05,NA,4.05,,1.01,10.63,10.63,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45357220,,Revision of urethra,A,,4.73,3.79,NA,3.79,,0.81,9.33,9.33,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45457230,,Repair of urethral lesion,A,,6.14,3.94,NA,3.94,,1.08,11.16,11.16,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45557240,,Anterior colporrhaphy,A,,9.83,4.88,NA,4.88,,1.61,16.32,16.32,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,45657250,,Repair rectum & vagina,A,,9.83,4.85,NA,4.85,,1.65,16.33,16.33,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00