53450
No office rateUrethral revision
Both describe single-stage hypospadias urethroplasty. Choose 53460 when the operative report supports extensive dissection to address chordee and the urethral defect.
On this page
CMS RVU26D · Effective 2026-10-01
53460 Urethroplasty Medicare reimbursement rates in Wisconsin
Reports single-stage urethral reconstruction for hypospadias when extensive dissection addresses the urethral defect and associated chordee. Compare 53460 office and facility rates across CMS payment localities in Wisconsin.
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 53460 in Wisconsin?
Wisconsin 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
$392.93
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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.
Urologic surgery
About 53460: Single-stage hypospadias urethroplasty with extensive dissection
Reports single-stage urethral reconstruction for hypospadias when extensive dissection addresses the urethral defect and associated chordee.
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.
CMS billing rules for 53460
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.56 · 60%
- Practice expense (office) RVU4.07 · 32%
- Malpractice RVU0.99 · 8%
29
Medicare services in 2024 · #5692 by national volume
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.
53460 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
53420 is for the first stage of a staged urethral reconstruction; 53460 describes a single-stage hypospadias repair.
No office rate
53425 represents the second stage of a staged reconstruction, not a single-stage repair.
No office rate
53410 describes single-stage reconstruction of the male anterior urethra; 53460 is specifically for extensive single-stage hypospadias correction.
Compare 53460 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$392.93
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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 53460 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
6,212
- Code
- 53460
- Physician work
- 7.56
- Practice expense
- 4.07
- Malpractice
- 0.99
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.56 | × 1.000 | 7.5600 |
| Practice expense | 4.07 | × 0.958 | 3.8991 |
| Malpractice | 0.99 | × 0.308 | 0.3049 |
| Total RVUs | 11.7640 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$392.93
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.56 | 1 |
| Practice expense | 4.07 | 0.958 |
| Malpractice | 0.99 | 0.308 |
(7.56 × 1 + 4.07 × 0.958 + 0.99 × 0.308) × $33.4009 = $392.93
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.
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 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.
6,20953452,,Tprnl balo cntnc dev uni,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,010,0.10,0.80,0.10,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,21053453,,Tprnl balo cntnc dev rmvl ea,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,21153454,,Tprnl balo cntnc dev adjmt,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,21253460,,Revision of urethra,A,,7.56,4.07,NA,4.07,,0.99,12.62,12.62,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,21353500,,Urethrlys transvag w/ scope,A,,12.68,5.53,NA,5.53,,1.93,20.14,20.14,0,090,0.12,0.74,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,21453502,,Repair of urethra injury,A,,8.05,4.28,NA,4.28,,1.05,13.38,13.38,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,21553505,,Repair of urethra injury,A,,8.05,4.27,NA,4.27,,1.05,13.37,13.37,0,090,0.08,0.83,0.09,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,