Billing code 51535: Ureterocele repairMedicare rate & RVUs in Oregon
Reports surgical treatment of a ureterocele through a bladder incision, rather than endoscopic incision of the ureterocele through the urethra.
CMS doesn’t publish an office rate for 51535 in Oregon.
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 51535 covers
A urologist uses a surgical bladder opening to expose and excise a ureterocele, a dilation of the distal ureter that protrudes into the bladder. This approach may be used when the ureterocele requires operative treatment, such as for urinary obstruction or recurrent infection. The service is generally performed in an operating room, with the operative report identifying the ureterocele and the surgical approach.
Report the code for the cystotomy-based excision, not for endoscopic incision through the urethra. Document the treated side or sides, the ureterocele, and the work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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.
Where 51535 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $718.29 |
| Rest Of Oregon | Unavailable | $686.39 |
How the 51535 rate is calculated
Each of 51535’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 · 51535
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.55Practice expense 5.80Malpractice 1.74
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 51535
51535 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 51535
Ureterocele repair
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 · 51535
Ureterocele repair
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 50 · payment effect
With and without the modifier
51535 without 50 · national facility
$704.42
Ureterocele repair
51535-50 · Bilateral: 150%
$1,056.63
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
51535 compared with similar codes
Compare codes
51535 vs 52301 vs 51520 vs 51525 vs 51530: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 52301Ureterocele treatment
- Use 52301 for endoscopic incision of a ureterocele through the urethra. Use 51535 when the ureterocele is treated by excision through cystotomy.
- 51520Bladder diverticulectomy
- 51520 addresses a bladder lesion through cystotomy. This code is for a ureterocele, a lesion involving the distal ureter at the bladder.
- 51525Bladder surgery
- 51525 is for excision of a bladder diverticulum through cystotomy. It does not describe excision of a ureterocele.
- 51530Bladder tumor excision
- 51530 describes cystotomy treatment of bladder tumor(s). Choose this code for ureterocele excision instead when that is the operative target.
51535 billing questions
How does this differ from endoscopic ureterocele treatment?
This code describes excision through a surgical bladder incision. billing code 52301 is the endoscopic alternative for incision of a ureterocele through the urethra.
Can bladder lesion or diverticulum codes be used instead?
No. Select the code that matches the operative target and work: this service treats a ureterocele, while bladder lesion and diverticulum codes describe different procedures.
What documentation supports reporting this code?
The operative report should identify the ureterocele, the side treated, the cystotomy-based approach, and the excision or repair performed.
How is bilateral treatment reported?
For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.
What payment rules apply when other procedures are performed in the same session?
The highest-valued procedure is paid in full and the other procedures are paid at 50%. The 90-day global period includes the day-before preoperative visit and related postoperative care.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. 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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