Billing code 51565: Bladder surgeryMedicare rate & RVUs in Oregon
Reports partial bladder removal with reimplantation of one or both ureters into the remaining bladder, such as for a lesion involving a ureteral opening.
CMS doesn’t publish an office rate for 51565 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 51565 covers
This operation removes part of the bladder and relocates one or both ureteral openings into the bladder that remains. Urologists perform it when the excised bladder segment includes a ureteral insertion or when ureteral drainage must be restored after the bladder resection. A typical situation is selected bladder tumor surgery involving a ureteral orifice. The procedure is performed in an operating room under anesthesia.
Report this code when both partial bladder excision and ureteral reimplantation are performed; documentation should identify the bladder segment removed and the ureter or ureters reimplanted. Medicare treats it as major surgery with a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. 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 51565 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,169.08 |
| Rest Of Oregon | Unavailable | $1,120.41 |
How the 51565 rate is calculated
Each of 51565’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 · 51565
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 23.09Practice expense 8.40Malpractice 2.97
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 51565
51565 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 51565
Bladder surgery
| 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 · 51565
Bladder surgery
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
51565 without 51 · national facility
$1,151.00
Bladder surgery
51565-51 · Second procedure: 50%
$575.50
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%).
51565 compared with similar codes
Compare codes
51565 vs 51550 vs 51555 vs 50780 vs 51570: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 51550Partial cystectomy
- 51550 is for partial bladder excision without ureteral reimplantation. Choose 51565 when the operation also reimplants one or both ureters.
- 51555Partial cystectomy
- 51555 describes complicated partial bladder excision without ureteral reimplantation; 51565 includes reimplantation as part of the operation.
- 50780Ureter reimplantation
- 50780 represents ureteral reimplantation without the partial bladder excision captured by 51565.
- 51570Cystectomy
- 51570 describes complete bladder removal. 51565 is for an operation that removes only part of the bladder and reimplants ureteral drainage.
51565 billing questions
When should I report this instead of 51550 or 51555?
Use 51565 when the partial bladder excision includes reimplantation of one or both ureters. Codes 51550 and 51555 describe partial bladder excision without that reimplantation.
Can the ureteral reimplantation be billed separately?
The reimplantation is part of the service represented by 51565. Do not separately report the same reimplantation as though it were an independent service.
Should modifier 50 be used when both ureters are reimplanted?
No. CMS identifies bilateral adjustment as inappropriate for this code, including when the operative work involves both ureters.
What documentation supports reporting 51565?
The operative report should describe the partial bladder resection and identify the ureter or ureters reimplanted into the remaining bladder.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the global surgery payment.
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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