Billing code 53410: Urethral reconstructionMedicare rate & RVUs in Washington
Reports a single-stage reconstructive operation on the male anterior urethra, such as repair of a urethral stricture or defect.
CMS doesn’t publish an office rate for 53410 in Washington.
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 53410 covers
A urologist uses this code for one-stage reconstruction of the male anterior urethra, commonly to restore the channel affected by a stricture or tissue defect. The operation may use local tissue or a graft to rebuild the narrowed or damaged segment. These procedures are generally performed in a surgical facility, with the operative report identifying the urethral site and reconstructive approach.
Select this code when the surgeon completes the anterior urethral reconstruction in one stage; a planned two-stage reconstruction follows the applicable stage-specific codes instead. Documentation should establish the anatomy treated, the reason for reconstruction, and the technique and extent of the repair. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is 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.
Where 53410 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $881.37 |
| Seattle (King Cnty) | Unavailable | $946.76 |
How the 53410 rate is calculated
Each of 53410’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 · 53410
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.24Practice expense 6.87Malpractice 2.22
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 53410
53410 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53410
Urethral reconstruction
| 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 · 53410
Urethral reconstruction
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
53410 without 51 · national facility
$879.45
Urethral reconstruction
53410-51 · Second procedure: 50%
$439.73
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%).
53410 compared with similar codes
Compare codes
53410 vs 53415 vs 53420 vs 53425 vs 53430: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 53415Urethroplasty
- This code concerns one-stage reconstruction of the male anterior urethra. Code 53415 is for one-stage reconstruction involving the prostatic or membranous urethra.
- 53420Urethral reconstruction
- Code 53420 represents the first stage of a planned two-stage male anterior urethral reconstruction; this code is for reconstruction completed in one stage.
- 53425Urethral reconstruction
- Code 53425 represents the second stage of a planned two-stage male anterior urethral reconstruction, rather than a one-stage repair.
- 53430Urethral repair
- Code 53430 is for female urethral reconstruction. This code is specific to the male anterior urethra.
53410 billing questions
How is this distinguished from a two-stage anterior urethral reconstruction?
Use this code when the reconstruction is completed in one stage. For a planned two-stage reconstruction, report the applicable first- or second-stage code.
What operative details support reporting this code?
The report should identify the male anterior urethral segment treated, the stricture or defect being repaired, and the reconstructive method and extent.
Are related postoperative visits separately reported?
Related postoperative care during the 90-day global period is included. The global period also includes the day-before preoperative visit.
Can modifier 50 be used for bilateral reconstruction?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used to represent bilateral work.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. Assistant-at-surgery payment may be made; co-surgeon claims need supporting documentation.
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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