$159.66–$172.79
53200 describes biopsy of the urethra for tissue sampling. Use 53250 when the operative service removes Skene gland tissue.
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CMS RVU26D · Effective 2026-10-01
53250 Gland excision Medicare reimbursement rates in Pennsylvania
Removal of Skene glands is reported for surgical treatment of symptomatic periurethral gland disease when the gland tissue itself is excised. Compare 53250 office and facility rates across CMS payment localities in Pennsylvania.
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 53250 in Pennsylvania?
Pennsylvania 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
$355.44–$381.75
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 53250: Excision of Skene glands
Removal of Skene glands is reported for surgical treatment of symptomatic periurethral gland disease when the gland tissue itself is excised.
This procedure removes Skene glands, the small paraurethral glands near the urethral opening, typically in a patient with symptomatic gland disease such as a cyst or recurrent inflammation. A urologist or urogynecologist generally performs the excision in an operating-room setting. The operative report should identify the gland tissue removed and describe the surgical work, rather than documenting only a biopsy or treatment of a urethral lesion.
Report 53250 when the documented service is excision of Skene glands; use the code that matches the actual structure and extent treated if the operation instead addresses another urethral condition. Medicare 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 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 53250
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.36 · 58%
- Practice expense (office) RVU3.82 · 35%
- Malpractice RVU0.82 · 7%
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.
53250 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
53230 addresses excision of a urethral diverticulum. Choose 53250 when the operative target is Skene gland tissue instead.
$209.88–$227.77
Both codes are described as urethral-gland removal codes in CMS data. Distinguish them by the full current CPT descriptors and the documented extent of the operation.
Compare 53250 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
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$381.75
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$355.44
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53250 billing questions
When should 53250 be chosen over a urethral biopsy?
Use 53250 when Skene gland tissue is surgically excised. A urethral biopsy code describes sampling tissue for diagnosis, not removal of the gland.
Does the 90-day global period include routine postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Should modifier 50 be appended for glands on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
How is 53250 paid when another procedure is done in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
What documentation supports reporting 53250?
Document the Skene gland tissue removed and the operative work performed. Documentation of a urethral lesion or diverticulum alone does not establish gland excision.
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.
6,18353230,,Removal of urethra lesion,A,,10.18,4.94,NA,4.94,,1.47,16.59,16.59,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18453235,,Removal of urethra lesion,A,,10.72,5.21,NA,5.21,,1.36,17.29,17.29,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18553240,,Surgery for urethra pouch,A,,6.90,3.95,NA,3.95,,0.89,11.74,11.74,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18653250,,Removal of urethra gland,A,,6.36,3.82,NA,3.82,,0.82,11.00,11.00,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18753260,,Treatment of urethra lesion,A,,2.95,3.02,,1.58,,0.43,6.40,4.96,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18853265,,Treatment of urethra lesion,A,,3.09,3.38,,1.55,,0.46,6.93,5.10,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,18953270,,Removal of urethra gland,A,,3.06,3.10,,1.61,,0.40,6.56,5.07,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00