Billing code 53448: Sphincter replacementMedicare rate & RVUs in Ohio
Reports removal and replacement of urinary sphincter components, typically during operative management of a malfunctioning or otherwise unsuitable artificial urinary sphincter.
CMS doesn’t publish an office rate for 53448 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 53448 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,119.27 |
How the 53448 rate is calculated
Each of 53448’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 · 53448
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 22.85Practice expense 8.43Malpractice 2.94
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 53448
53448 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53448
Sphincter replacement
| 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 · 53448
Sphincter replacement
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
53448 without 51 · national facility
$1,142.98
Sphincter replacement
53448-51 · Second procedure: 50%
$571.49
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%).
53448 compared with similar codes
Compare codes
53448 vs 53446 vs 53445 vs 53447 vs 53449: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 53446Sphincter removal
- Use 53446 when the urinary sphincter is removed without replacement. Use 53448 when the documented service includes component replacement.
- 53445Artificial sphincter
- Code 53445 is for initial insertion of an inflatable urinary sphincter system; 53448 concerns removal and replacement of components in an existing system.
- 53447Sphincter replacement
- Both codes address urinary sphincter removal and replacement. Determine the appropriate code from the exact component work and procedure documented.
- 53449Sphincter repair
- Code 53449 describes sphincter repair. It is not the component replacement service reported with 53448.
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 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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