No office rate
53000 is the external urethrotomy code for a male patient; 53010 is for a female patient.
On this page
CMS RVU26D · Effective 2026-10-01
53010 Urethrotomy Medicare reimbursement rates in Utah
External urethrotomy in a female patient is reported when a surgeon incises a urethral narrowing to restore the urethral lumen. Compare 53010 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 53010 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
$272.26
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 53010: External urethrotomy, female
External urethrotomy in a female patient is reported when a surgeon incises a urethral narrowing to restore the urethral lumen.
A urologist performs an external urethrotomy to open a narrowed segment of the female urethra, typically for a urethral stricture causing impaired urine flow. The operation uses an external surgical approach rather than an endoscopic incision through a cystoscope. Medicare claims for this service are predominantly facility-based, consistent with the operative setting in which this procedure is performed.
Select this code for the external approach in a female patient, not for an incision confined to the urethral meatus or an endoscopic internal urethrotomy. The operative report should support the patient’s anatomy, the narrowed urethral segment, and the external incision performed. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care. When other 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 inappropriate. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 53010
- 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 RVU4.34 · 52%
- Practice expense (office) RVU3.51 · 42%
- Malpractice RVU0.57 · 7%
99
Medicare services in 2024 · #4893 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.
53010 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
53020 describes meatotomy, an incision at the urethral meatus. Use 53010 for the external urethrotomy of a urethral narrowing in a female patient.
No office rate
52276 is an endoscopic internal urethrotomy performed through a cystoscope. 53010 represents the external approach in a female patient.
$75.37
53660 is female urethral dilation; 53010 is an external surgical incision to open a urethral narrowing.
Compare 53010 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
$272.26
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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 53010 in Utah.
PPRRVU2026_Oct_nonQPP.csv
6,172
- Code
- 53010
- Physician work
- 4.34
- Practice expense
- 3.51
- Malpractice
- 0.57
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.34 | × 1.000 | 4.3400 |
| Practice expense | 3.51 | × 0.940 | 3.2994 |
| Malpractice | 0.57 | × 0.898 | 0.5119 |
| Total RVUs | 8.1513 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$272.26
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.34 | 1 |
| Practice expense | 3.51 | 0.94 |
| Malpractice | 0.57 | 0.898 |
(4.34 × 1 + 3.51 × 0.94 + 0.57 × 0.898) × $33.4009 = $272.26
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.
53010 billing questions
How does this differ from code 53000?
Code 53010 is for external urethrotomy in a female patient; 53000 is the corresponding male service. The operative documentation should support the patient anatomy and external approach.
When should 53010 be used instead of 52276?
Use 53010 for an external urethrotomy in a female patient. Code 52276 describes an endoscopic internal urethrotomy performed through a cystoscope.
Is an incision of the urethral meatus reported with 53010?
No. An incision limited to the urethral meatus is a meatotomy, not the external urethrotomy represented by 53010.
Can modifier 50 be appended?
No. Modifier 50 is inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for the urethrotomy.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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.
6,16952649,,Prostate laser enucleation,A,,12.68,5.36,NA,5.36,,1.63,19.67,19.67,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17052700,,Drainage of prostate abscess,A,,7.30,3.91,NA,3.91,,0.93,12.14,12.14,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17153000,,Incision of urethra,A,,2.27,1.60,NA,1.60,,0.28,4.15,4.15,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17253010,,Incision of urethra,A,,4.34,3.51,NA,3.51,,0.57,8.42,8.42,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17353020,,Incision of urethra,A,,1.73,0.64,NA,0.64,,0.21,2.58,2.58,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17453025,,Incision of urethra,A,,1.10,0.64,NA,0.64,,0.14,1.88,1.88,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17553040,,Drainage of urethra abscess,A,,6.39,3.64,NA,3.64,,0.82,10.85,10.85,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,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