Billing code 53250: Gland excisionMedicare rate & RVUs in Utah
Removal of Skene glands is reported for surgical treatment of symptomatic periurethral gland disease when the gland tissue itself is excised.
CMS doesn’t publish an office rate for 53250 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 53250 covers
This procedure removes Skene glands, the small paraurethral glands near the urethral opening, typically in a patient with symptomatic gland disease such as a cyst or recurrent inflammation. A urologist or urogynecologist generally performs the excision in an operating-room setting. The operative report should identify the gland tissue removed and describe the surgical work, rather than documenting only a biopsy or treatment of a urethral lesion.
Report 53250 when the documented service is excision of Skene glands; use the code that matches the actual structure and extent treated if the operation instead addresses another urethral condition. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. 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% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting are 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.
53250 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $356.96 |
How the 53250 rate is calculated
Each of 53250’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 · 53250
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.36Practice expense 3.82Malpractice 0.82
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 53250
53250 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53250
Gland 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 53250
Gland 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
53250 without 51 · national facility
$367.41
Gland excision
53250-51 · Second procedure: 50%
$183.71
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%).
53250 compared with similar codes
Compare codes
53250 vs 53200 vs 53230 vs 53270: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 53200Urethral biopsy
- 53200 describes biopsy of the urethra for tissue sampling. Use 53250 when the operative service removes Skene gland tissue.
- 53230Lesion excision
- 53230 addresses excision of a urethral diverticulum. Choose 53250 when the operative target is Skene gland tissue instead.
- 53270Gland excision
- Both codes are described as urethral-gland removal codes in CMS data. Distinguish them by the full current billing code descriptors and the documented extent of the operation.
53250 billing questions
When should 53250 be chosen over a urethral biopsy?
Use 53250 when Skene gland tissue is surgically excised. A urethral biopsy code describes sampling tissue for diagnosis, not removal of the gland.
Does the 90-day global period include routine postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Should modifier 50 be appended for glands on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
How is 53250 paid when another procedure is done in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
What documentation supports reporting 53250?
Document the Skene gland tissue removed and the operative work performed. Documentation of a urethral lesion or diverticulum alone does not establish gland excision.
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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