No office rate
This is for excision of a bladder diverticulum through a bladder opening. Code 51500 instead addresses a urachal cyst or sinus outside the bladder lumen.
On this page
CMS RVU26D · Effective 2026-10-01
51500 Urachal excision Medicare reimbursement rates in Utah
Excision of a urachal cyst or sinus is reported to remove a persistent urachal remnant, often extending between the umbilicus and bladder dome. Compare 51500 office and facility rates across CMS payment localities in Utah.
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 51500 in Utah?
Utah has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$565.02
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
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 51500: Urachal cyst or sinus excision
Excision of a urachal cyst or sinus is reported to remove a persistent urachal remnant, often extending between the umbilicus and bladder dome.
This operation removes a persistent urachal remnant, such as a cyst or draining sinus running between the umbilicus and the bladder dome. Urologists commonly perform it in a hospital operating room; pediatric surgeons may also manage these remnants in children. Patients may present with a midline mass, drainage at the umbilicus, or infection. The code includes the excision whether or not an associated umbilical hernia is repaired.
Select this service for excision of a urachal cyst or sinus, not for an intravesical diverticulum or bladder tumor. The operative report should identify the remnant and describe its dissection and removal, including any bladder or umbilical work. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. The urachus is a single midline structure, so modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 51500
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.77 · 62%
- Practice expense (office) RVU5.23 · 30%
- Malpractice RVU1.37 · 8%
60
Medicare services in 2024 · #5239 by national volume
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.
51500 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
This is used for complicated bladder-diverticulum excision. It does not describe removal of a urachal remnant.
No office rate
This is for bladder tumor excision through a bladder opening. Choose 51500 when the operative target is a urachal cyst or sinus, not a bladder tumor.
Compare 51500 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.
1 of 1 payment localities
Utah →
Office / nonfacility
Unavailable
Facility
$565.02
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 51500 in Utah.
PPRRVU2026_Oct_nonQPP.csv
6,026
- Code
- 51500
- Physician work
- 10.77
- Practice expense
- 5.23
- Malpractice
- 1.37
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.77 | × 1.000 | 10.7700 |
| Practice expense | 5.23 | × 0.940 | 4.9162 |
| Malpractice | 1.37 | × 0.898 | 1.2303 |
| Total RVUs | 16.9165 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$565.02
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.77 | 1 |
| Practice expense | 5.23 | 0.94 |
| Malpractice | 1.37 | 0.898 |
(10.77 × 1 + 5.23 × 0.94 + 1.37 × 0.898) × $33.4009 = $565.02
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
51500 billing questions
When should this code be chosen instead of a bladder lesion code?
Use it for excision of a urachal cyst or sinus, a remnant associated with the tract between the umbilicus and bladder. A bladder diverticulum or tumor is a different operative target.
Is umbilical hernia repair separately reported?
The service includes excision with or without repair of an associated umbilical hernia. The hernia repair is not separately reported as an additional service under this code.
Can modifier 50 be appended?
No. The urachus is a single midline structure, and modifier 50 is inappropriate.
How does the 90-day global period affect postoperative visits?
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?
An assistant at surgery may be paid. 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 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.
6,02351100,,Drain bladder by needle,A,,0.76,1.38,,0.16,,0.09,2.23,1.01,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,02451101,,Drain bladder by trocar/cath,A,,0.99,3.55,,0.21,,0.13,4.67,1.33,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,02551102,,Drain bl w/cath insertion,A,,2.63,4.26,,0.81,,0.33,7.22,3.77,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,02651500,,Removal of bladder cyst,A,,10.77,5.23,NA,5.23,,1.37,17.37,17.37,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,02751520,,Removal of bladder lesion,A,,9.95,5.06,NA,5.06,,1.29,16.30,16.30,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,02851525,,Removal of bladder lesion,A,,15.03,6.12,NA,6.12,,2.00,23.15,23.15,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,02951530,,Removal of bladder lesion,A,,13.37,5.76,NA,5.76,,1.72,20.85,20.85,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985