Billing code 57230: Urethral repairMedicare rate & RVUs in Wyoming
Surgical repair of a female urethral lesion, commonly a diverticulum, reported when the procedure treats and closes the affected urethral tissue.
CMS doesn’t publish an office rate for 57230 in Wyoming.
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 57230 covers
This procedure treats a lesion involving the female urethra, with a urethral diverticulum as a typical clinical example. A urologist or urogynecologist commonly performs the repair in an operating room, often through a vaginal approach, exposing the lesion and repairing the urethral tissue after treating it. The operative report should identify the lesion, its relationship to the urethra, and the repair performed.
Report the code for the urethral lesion repair itself, rather than for repair of an adjacent vaginal-wall prolapse or a urethral reconstruction performed for a different condition. This is major surgery with a 90-day global period; the day-before preoperative visit and related postoperative care during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires 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.
57230 in Wyoming**
| Payment locality | Office | Facility |
|---|---|---|
| Wyoming** | Unavailable | $363.38 |
How the 57230 rate is calculated
Each of 57230’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 · 57230
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.14Practice expense 3.94Malpractice 1.08
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 57230
57230 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 57230
Urethral repair
| 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) | 0.12/0.74/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 57230
Urethral repair
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
57230 without 51 · national facility
$372.75
Urethral repair
57230-51 · Second procedure: 50%
$186.38
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%).
57230 compared with similar codes
Compare codes
57230 vs 57220 vs 53430 vs 57240: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 57220Urethral revision
- This code addresses repair of a urethral lesion. Code 57220 is identified as urethral revision and is not selected solely because the operation involves the urethra.
- 53430Urethral repair
- Use 57230 for repair of a urethral lesion. Code 53430 describes female urethral reconstruction, a different operative purpose.
- 57240Anterior repair
- Code 57240 addresses anterior vaginal wall repair. It is not the urethral lesion repair represented by 57230.
57230 billing questions
When is this code more appropriate than a urethral reconstruction code?
Use it when the operation repairs a urethral lesion, such as a diverticulum. A reconstructive urethroplasty code is for reconstruction of the urethra rather than repair of a lesion.
Is a urethral diverticulum a typical reason for reporting this code?
Yes. A diverticulum is a typical example of a lesion treated by this repair; the operative note should describe the lesion and the urethral repair.
Can modifier 50 be reported for a lesion on each side?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
How does the 90-day global period affect postoperative visits?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the global surgery payment.
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 when performed in the same session.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; 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 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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