Billing code 53215: UrethrectomyMedicare rate & RVUs in Ohio
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.
CMS doesn’t publish an office rate for 53215 in Ohio.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 53215 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $814.74 |
How the 53215 rate is calculated
Each of 53215’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 53215
RVUs × geographic indexes × conversion factor
Work16.43
16.43 RVUs× 1.000 GPCI
Practice expense6.37
6.37 RVUs× 1.000 GPCI
Malpractice2.13
2.13 RVUs× 1.000 GPCI
Adjusted RVUs
24.9300
Conversion factor
$33.4009
Medicare rate
$832.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53215
53215 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53215
Urethrectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 53215
Urethrectomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
53215 without 51 · national facility
$832.68
Urethrectomy
53215-51 · Second procedure: 50%
$416.34
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
53215 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 53210Urethrectomy
- This code is for total urethral removal in a male. Code 53210 is the corresponding total-removal code for a female patient.
- 53230Lesion excision
- Code 53215 is for removal of the entire male urethra; code 53230 concerns removal of a urethral lesion, not the whole urethra.
- 53200Urethral biopsy
- Code 53200 is for obtaining a urethral biopsy specimen. Code 53215 represents definitive removal of the entire male urethra.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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