Billing code 53447: Sphincter replacementMedicare rate & RVUs in Texas
Reported when a surgeon removes an existing artificial urinary sphincter and replaces the complete device, rather than replacing a component alone.
CMS doesn’t publish an office rate for 53447 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 53447 covers
A urologist removes an implanted artificial urinary sphincter and places a replacement system, including its principal device components. This operation may be performed when an existing system requires replacement, such as after device failure or another complication that makes continued use unsuitable. It is generally performed in an operating-room setting; the operative report should identify the existing device, the reason for replacement, and the components removed and implanted.
Report this code for complete device removal and replacement, not removal alone, insertion without removal, or replacement of an individual component. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. 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% multiple-procedure reduction. Modifier 50 is not appropriate for this single-device service. 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 53447 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 | $736.94 |
| Beaumont | Unavailable | $708.01 |
| Brazoria | Unavailable | $719.59 |
| Dallas | Unavailable | $725.73 |
| Fort Worth | Unavailable | $724.44 |
| Galveston | Unavailable | $722.86 |
| Houston | Unavailable | $755.44 |
| Rest Of Texas | Unavailable | $714.52 |
How the 53447 rate is calculated
Each of 53447’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 · 53447
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.92Practice expense 6.18Malpractice 1.78
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 53447
53447 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53447
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 · 53447
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
53447 without 51 · national facility
$730.81
Sphincter replacement
53447-51 · Second procedure: 50%
$365.41
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%).
53447 compared with similar codes
Compare codes
53447 vs 53445 vs 53446 vs 53448 vs 53449: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 53445Artificial sphincter
- Choose 53445 for sphincter insertion without removal of an existing device; 53447 includes both removal and replacement.
- 53446Sphincter removal
- 53446 covers removal alone. When a replacement system is also implanted during the service, consider 53447.
- 53448Sphincter replacement
- 53448 is for removal and replacement of a component, while 53447 represents replacement of the complete urinary sphincter system.
- 53449Sphincter repair
- 53449 describes sphincter repair. Use 53447 when the service removes the existing system and replaces it rather than repairing it.
53447 billing questions
When is 53447 reported instead of 53445?
Use 53447 when the existing urinary sphincter is removed and a replacement system is implanted. Code 53445 describes insertion without removal of an existing sphincter.
How does 53447 differ from 53448?
53447 represents removal and replacement of the complete system. Use 53448 when the operative service is limited to removal and replacement of a component.
Can removal be billed separately with 53447?
Removal is part of the complete removal-and-replacement service. Do not separately report removal alone for the same device work.
What documentation supports reporting 53447?
Document the indication for replacement, the existing sphincter removed, the replacement system implanted, and the components addressed during surgery.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can 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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