No office rate
51520 describes excision of a bladder diverticulum. Choose 51525 when the cystotomy is performed to remove a bladder tumor.
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CMS RVU26D · Effective 2026-10-01
51520 Bladder diverticulectomy Medicare reimbursement rates in Vermont
Report 51520 for open excision of one or more bladder diverticula through cystotomy, rather than for tumor removal or partial cystectomy. Compare 51520 office and facility rates across CMS payment localities in Vermont.
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 51520 in Vermont?
Vermont 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
$521.46
1 of 1 localities have a supported rate.
Payment area: Vermont
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 51520: Open bladder diverticulum excision
Report 51520 for open excision of one or more bladder diverticula through cystotomy, rather than for tumor removal or partial cystectomy.
51520 represents an open bladder operation in which the surgeon enters the bladder through a cystotomy and removes one or more bladder diverticula. A diverticulum is an outpouching of the bladder wall; this service is distinct from transurethral removal of an intravesical tumor. Urologists typically perform it in an operating room when operative excision of the diverticulum is planned.
Choose 51520 when the operative work is excision of bladder diverticulum through cystotomy, whether one or multiple diverticula are removed. The operative report should identify the diverticulum or diverticula and describe the cystotomy and excision, distinguishing the service from tumor removal or a broader partial cystectomy. CMS assigns a 90-day major-surgery global period: the day-before preoperative visit and 90 days of related postoperative care are included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 51520
- 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 RVU9.95 · 61%
- Practice expense (office) RVU5.06 · 31%
- Malpractice RVU1.29 · 8%
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.
51520 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
51530 is for bladder tumor excision that includes partial cystectomy. 51520 is for diverticulum excision, not tumor removal with bladder resection.
No office rate
51550 describes simple partial cystectomy. Use 51520 when the documented operation is excision of one or more diverticula through cystotomy.
No office rate
51555 describes complicated partial cystectomy. It is not the diverticulectomy service represented by 51520.
Compare 51520 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
Vermont →
Office / nonfacility
Unavailable
Facility
$521.46
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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 51520 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
6,027
- Code
- 51520
- Physician work
- 9.95
- Practice expense
- 5.06
- Malpractice
- 1.29
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.95 | × 1.000 | 9.9500 |
| Practice expense | 5.06 | × 0.990 | 5.0094 |
| Malpractice | 1.29 | × 0.506 | 0.6527 |
| Total RVUs | 15.6121 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$521.46
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.95 | 1 |
| Practice expense | 5.06 | 0.99 |
| Malpractice | 1.29 | 0.506 |
(9.95 × 1 + 5.06 × 0.99 + 1.29 × 0.506) × $33.4009 = $521.46
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.
51520 billing questions
When should 51520 be used instead of 51525?
Use 51520 for excision of a bladder diverticulum through cystotomy. Use 51525 when the cystotomy is for excision of a bladder tumor.
Is each diverticulum reported as a separate unit?
No. The code covers excision of a single diverticulum or multiple diverticula; the number removed alone does not establish separate units.
Does the 90-day global period include postoperative care?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor and anatomy.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeons require supporting documentation, and 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.
6,02451101,,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
6,03051535,,Repair of ureter lesion,A,,13.55,5.80,NA,5.80,,1.74,21.09,21.09,0,090,0.08,0.83,0.09,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817