Billing code 53235: Urethral excisionMedicare rate & RVUs in Utah
Reports surgical excision of a urethral lesion in a female patient when the lesion is removed rather than sampled by biopsy or destroyed.
CMS doesn’t publish an office rate for 53235 in Utah.
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 53235 covers
This service involves surgically removing a lesion from the female urethra. A urologist or another surgeon with appropriate expertise typically performs the procedure in a facility setting. The excised tissue may be submitted for pathologic examination. This code describes removal of a lesion, not a limited tissue sample for diagnosis or destruction of the lesion without excision.
Report the code for the female patient when the operative record supports excision of a urethral lesion. Document the lesion’s location and appearance, the operative approach, and the work performed to remove it. The code has a 90-day global period: the day-before preoperative visit and related postoperative care during that period are included. 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% multiple-procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is not appropriate for this descriptor and anatomy.
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.
53235 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $562.43 |
How the 53235 rate is calculated
Each of 53235’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 · 53235
RVUs × geographic indexes × conversion factor
Work10.72
10.72 RVUs× 1.000 GPCI
Practice expense5.21
5.21 RVUs× 1.000 GPCI
Malpractice1.36
1.36 RVUs× 1.000 GPCI
Adjusted RVUs
17.2900
Conversion factor
$33.4009
Medicare rate
$577.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53235
53235 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53235
Urethral excision
| 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 · 53235
Urethral excision
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
53235 without 51 · national facility
$577.50
Urethral excision
53235-51 · Second procedure: 50%
$288.75
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%).
53235 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 53230Lesion excision
- 53230 is the male counterpart. 53235 is for excision of a urethral lesion in a female patient.
- 53200Urethral biopsy
- 53200 reports biopsy sampling of the urethra. Choose 53235 when the operative service removes the lesion.
- 53260Lesion destruction
- 53260 is for destruction of a urethral lesion. 53235 represents surgical excision.
- 53265Urethral treatment
- 53265 is also a urethral lesion destruction code. Use the destruction code when the lesion is destroyed rather than removed by excision.
53235 billing questions
How does this code differ from 53230?
53235 is for excision of a urethral lesion in a female patient; 53230 is the corresponding male code. Select based on the patient and operative service.
When should 53200 be reported instead?
53200 describes a urethral biopsy, in which tissue is sampled for diagnosis. Use 53235 when the documented service is excision of the lesion rather than a biopsy.
Can lesion destruction codes be used instead?
Codes 53260 and 53265 describe destruction of a urethral lesion. They are alternatives when the lesion is destroyed rather than surgically excised.
Should modifier 50 be appended?
No. Modifier 50 is not appropriate for this descriptor and anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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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