Billing code 53460: UrethroplastyMedicare rate & RVUs in Washington
Reports single-stage urethral reconstruction for hypospadias when extensive dissection addresses the urethral defect and associated chordee.
CMS doesn’t publish an office rate for 53460 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 53460 covers
A urologist performs this operation to correct hypospadias by reconstructing the urethra in one stage, with extensive dissection to address the urethral defect and chordee. The work may involve mobilizing urethral tissue and using local tissue to create or restore the urethral channel. It is typically performed in an operating room rather than an office setting.
Choose this code when the operative report supports a single-stage hypospadias repair requiring the extensive dissection described for this service; distinguish it from the less extensive single-stage repair and from staged reconstruction. Documentation should identify the hypospadias, the urethral work, and the dissection performed to correct chordee or the urethral defect. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery 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.
Where 53460 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $424.10 |
| Seattle (King Cnty) | Unavailable | $458.95 |
How the 53460 rate is calculated
Each of 53460’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 · 53460
RVUs × geographic indexes × conversion factor
Work7.56
7.56 RVUs× 1.000 GPCI
Practice expense4.07
4.07 RVUs× 1.000 GPCI
Malpractice0.99
0.99 RVUs× 1.000 GPCI
Adjusted RVUs
12.6200
Conversion factor
$33.4009
Medicare rate
$421.52
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 53460
53460 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 53460
Urethroplasty
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 53460
Urethroplasty
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
53460 without 51 · national facility
$421.52
Urethroplasty
53460-51 · Second procedure: 50%
$210.76
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%).
53460 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 53450Urethral revision
- Both describe single-stage hypospadias urethroplasty. Choose 53460 when the operative report supports extensive dissection to address chordee and the urethral defect.
- 53420Urethral reconstruction
- 53420 is for the first stage of a staged urethral reconstruction; 53460 describes a single-stage hypospadias repair.
- 53425Urethral reconstruction
- 53425 represents the second stage of a staged reconstruction, not a single-stage repair.
- 53410Urethral reconstruction
- 53410 describes single-stage reconstruction of the male anterior urethra; 53460 is specifically for extensive single-stage hypospadias correction.
53460 billing questions
How does this differ from 53450?
Both concern single-stage hypospadias urethroplasty. Use 53460 when the operative documentation supports extensive dissection to correct chordee and the urethral defect; 53450 describes the less extensive repair.
When is a staged urethroplasty code more appropriate?
Use a staged reconstruction code when the surgeon plans or performs the repair in separate stages. This code describes a single-stage hypospadias repair with extensive dissection.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
How does Medicare handle another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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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