Billing code 51980: VesicostomyMedicare rate & RVUs in Texas
Reports surgical creation of a bladder opening to the skin for urinary drainage, commonly used when a patient cannot empty the bladder safely through the urethra.
CMS doesn’t publish an office rate for 51980 in Texas.
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 51980 covers
A vesicostomy creates a route from the bladder to the skin so urine can drain continuously through an abdominal opening. Pediatric urologists commonly perform the procedure for infants or children who need urinary diversion, such as when bladder outlet obstruction or impaired emptying makes urethral drainage unsuitable. The resulting opening is managed as a urinary stoma and may serve as a temporary diversion or longer-term drainage route, depending on the patient’s condition.
Report the service for creation of the cutaneous bladder opening, rather than for placement of a suprapubic drainage catheter or another form of cystostomy. The operative report should establish that a vesicostomy was constructed and describe the procedure and clinical reason for diversion. This major surgery has 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 procedure is paid in full and others at 50%. 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 51980 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $652.55 |
| Beaumont | Unavailable | $626.60 |
| Brazoria | Unavailable | $637.05 |
| Dallas | Unavailable | $642.47 |
| Fort Worth | Unavailable | $641.31 |
| Galveston | Unavailable | $639.94 |
| Houston | Unavailable | $668.67 |
| Rest Of Texas | Unavailable | $632.45 |
How the 51980 rate is calculated
Each of 51980’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 · 51980
RVUs × geographic indexes × conversion factor
Work12.26
12.26 RVUs× 1.000 GPCI
Practice expense5.54
5.54 RVUs× 1.000 GPCI
Malpractice1.57
1.57 RVUs× 1.000 GPCI
Adjusted RVUs
19.3700
Conversion factor
$33.4009
Medicare rate
$646.98
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 51980
51980 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 51980
Vesicostomy
| 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 · 51980
Vesicostomy
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
51980 without 51 · national facility
$646.98
Vesicostomy
51980-51 · Second procedure: 50%
$323.49
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%).
51980 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 51040Bladder drainage
- Choose 51980 when the surgeon constructs a bladder-to-skin opening for drainage. Code 51040 describes cystostomy with drainage, a distinct procedure.
- 51102Bladder drainage
- Code 51102 describes suprapubic catheter insertion using bladder aspiration. It does not represent construction of a vesicostomy.
- 51999Unlisted laps px bladder
- Code 51999 is for an unlisted laparoscopic bladder procedure when no specific code describes the service. It is not the specific vesicostomy code.
51980 billing questions
How is a vesicostomy different from a suprapubic catheter?
A vesicostomy creates a bladder-to-skin opening for ongoing drainage. A suprapubic catheter service places a drainage catheter through the abdominal wall rather than constructing a vesicostomy.
Can this code be reported with other procedures performed during the same operation?
It may be reported with separately performed procedures when each service is supported by the operative documentation. The CMS multiple-procedure reduction applies when procedures are performed in the same session: the highest-valued procedure is paid in full and others at 50%.
Should modifier 50 be used for a vesicostomy?
No. The CMS bilateral adjustment does not apply to this procedure, and modifier 50 is inappropriate.
What documentation supports reporting this code?
The operative report should show that the surgeon created a cutaneous opening from the bladder for urine drainage and document the reason urinary diversion was needed.
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?
Assistant-at-surgery payment may be made. Co-surgeons are paid only with 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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