CPT code 52000: Cystoscopy, diagnostic examination only2026 Medicare rate & RVUs in Montana

Report diagnostic cystourethroscopy to inspect the urethra and bladder when no more extensive cystourethroscopic procedure includes the examination during the same session.

CMS RVU26DEffective Oct 1, 2026One payment locality826.9K Medicare services in 2024

In Montana, Medicare pays $215.76 for 52000 in the office and $71.13 when it’s performed in a hospital or facility.

$215.76Office (non-facility)
$71.13Hospital or facility
−0.0%vs the national office rate ($215.77)

Check a contract rate as a % of Medicare · 52000 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 52000 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Montana
  2. What 52000 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 52000 covers

The clinician passes a flexible or rigid cystoscope through the urethra to inspect the urethral lining, bladder neck, bladder walls, and ureteral orifices. Urologists perform the examination most often, sometimes in an office using topical anesthetic gel and a flexible scope. It may also be performed in a hospital or ambulatory surgery center. Common reasons include hematuria, bladder cancer surveillance, recurrent urinary tract infections, voiding symptoms, and suspected urethral stricture.

Report 52000 for a diagnostic examination when a more extensive cystourethroscopy does not include it during the same session. A biopsy, ureteral catheterization, or clot evacuation performed through the scope calls for the applicable procedure code instead. Document the indication, structures examined, and findings. Its 0-day global period includes routine same-day preoperative and postoperative care; a significant, separately identifiable E/M service may be reported with modifier 25. When other procedures are separately reportable in the same session, the standard multiple-procedure rule pays the highest-valued procedure in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted. Office practice expense is higher than facility practice expense.

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.

How Montana compares for 52000

Across 109 of 109 payment localities, the office rate for 52000 runs from $190.07 in Arkansas to $288.57 in San Benito County, CA. Montana pays $215.76. The RVUs are the same everywhere; the geographic indexes change the dollars.

52000 in Montana vs other payment areas
  1. Montana · this page$215.76
  2. Los Angeles, CA · California$244.72+$28.96
  3. Washington, DC area · District of Columbia$247.57+$31.81
  4. Miami, FL · Florida$232.52+$16.76
  5. Chicago, IL · Illinois$225.57+$9.81
  6. Manhattan, NY · New York$248.68+$32.92
  7. Alaska · Alaska$248.01+$32.25

Other areas in Montana first, then benchmark localities. Bars start at $0.

Every other payment area

52000 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$192.96$66.41
ArkansasArkansas$190.07$65.83
ArizonaArizona$209.87$69.73
Bakersfield, CACalifornia$229.40$70.89
Chico, CACalifornia$228.81$70.30
El Centro, CACalifornia$228.84$70.33
Fresno, CACalifornia$228.81$70.30
Hanford, CACalifornia$228.81$70.30

52000 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$190.07

$258.69

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
52000 office rate range by state
State / territoryOffice rate rangeLocalities
AK$248.011
AL$192.961
AR$190.071
AZ$209.871
CA$228.81–$288.5729
CO$225.101
CT$230.441
DC$247.571
DE$213.431
FL$212.12–$232.523
GA$199.85–$219.812
GU$234.781
HI$234.781
IA$198.201
ID$199.501
IL$205.67–$225.584
IN$200.711
KS$197.161
KY$197.521
LA$197.17–$207.282
MA$223.65–$247.982
MD$217.63–$247.573
ME$200.50–$211.872
MI$202.77–$214.782
MN$215.691
MO$193.61–$208.143
MS$191.881
MT$215.761
NC$202.681
ND$211.801
NE$199.351
NH$221.471
NJ$233.07–$244.852
NM$203.891
NV$214.811
NY$205.82–$254.795
OH$201.961
OK$197.231
OR$213.15–$232.542
PA$202.34–$224.492
PR$217.421
RI$221.251
SC$202.661
SD$211.331
TN$198.181
TX$200.96–$224.358
UT$205.531
VA$211.10–$247.572
VI$217.421
VT$210.881
WA$223.26–$253.202
WI$204.461
WV$197.781
WY$214.031

See 52000 in every payment locality

How the 52000 rate is calculated

Each of 52000’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 · 52000

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.49

1.49 RVUs× 1.000 GPCI

Practice expense4.77

4.77 RVUs× 1.000 GPCI

Malpractice0.20

0.20 RVUs× 1.000 GPCI

Adjusted RVUs

6.4600

Conversion factor

$33.4009

Medicare rate

$215.77

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Montana inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,105

Code
52000
Physician work
1.49
Practice expense
4.77
Malpractice
0.20

GPCI2026.csv

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Office calculation for 52000 in Montana
ComponentRVULocality factorAdjusted
Physician work1.49× 1.0001.4900
Practice expense4.77× 1.0004.7700
Malpractice0.20× 0.9980.1996
Total RVUs6.4596
Conversion factor× 33.4009

Office rate, Montana$215.76

Office: (1.49 × 1 + 4.77 × 1 + 0.2 × 0.998) × $33.4009 = $215.76

Facility: (1.49 × 1 + 0.44 × 1 + 0.2 × 0.998) × $33.4009 = $71.13

Open 52000 in the RVU calculator

Payment rules and modifiers for 52000

The CMS indicators that decide how 52000 is paid alongside other services.

CMS payment indicators · 52000

Cystoscopy, diagnostic examination only

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

52000 without 51 · national office

$215.77

Cystoscopy, diagnostic examination only

52000-51 · Second procedure: 50%

$107.89

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%).

When to use modifier 51

How 52000 has changed in Montana

52000 · Office / nonfacility

$215.76

Effective 2026-10-01

The base rate is $2.72 higher than on 2025-10-01, moving from $213.04 to $215.76 (1.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $213.04changed to$215.76

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.53 changed to 1.49
    • Practice expense RVU 4.88 changed to 4.77
    • Malpractice RVU 0.18 changed to 0.20
    • Malpractice GPCI 0.978 changed to 0.998

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $239.20changed to$213.04

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.47 changed to 4.88
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $235.29changed to$239.20

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $244.19changed to$235.29

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.49 changed to 5.47
  5. January 1, 2023

    RVU23A

    $252.82changed to$244.19

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.59 changed to 5.49
    • Malpractice GPCI 0.977 changed to 0.978

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $240.97changed to$252.82

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.21 changed to 5.59
    • Malpractice RVU 0.17 changed to 0.19

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $218.15changed to$240.97

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.28 changed to 5.21
    • Malpractice RVU 0.18 changed to 0.17
    • Malpractice GPCI 1.304 changed to 0.977

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $198.12changed to$218.15

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.69 changed to 4.28
    • Malpractice RVU 0.17 changed to 0.18
    • Malpractice GPCI 1.631 changed to 1.304

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $174.14changed to$198.12

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.03 changed to 3.69

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $170.58changed to$174.14

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.98 changed to 3.03
    • Malpractice GPCI 1.429 changed to 1.631

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $209.69changed to$170.58

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 2.23 changed to 1.53
    • Practice expense RVU 3.32 changed to 2.98
    • Malpractice RVU 0.25 changed to 0.17
    • Malpractice GPCI 1.226 changed to 1.429

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $210.53changed to$209.69

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.31 changed to 3.32
    • Malpractice RVU 0.26 changed to 0.25

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $209.48changed to$210.53

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $204.42changed to$209.48

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.22 changed to 3.31
    • Malpractice RVU 0.22 changed to 0.26
    • Malpractice GPCI 1.165 changed to 1.226

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $203.24changed to$204.42

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.49 changed to 3.22
    • Malpractice RVU 0.23 changed to 0.22
    • Malpractice GPCI 1.103 changed to 1.165

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $203.24

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$215.76$71.13RVU26D
2026-07-01$215.76$71.13RVU26C
2026-04-01$215.76$71.13RVU26B
2026-01-01$215.76$71.13RVU26A
2025-10-01$213.04$77.18RVU25D
2025-07-01$213.04$77.18RVU25C
2025-04-01$213.04$77.18RVU25B
2025-01-01$213.04$77.18RVU25A
2024-10-01$239.20$79.09RVU24D
2024-07-01$239.20$79.09RVU24C
2024-04-01$239.20$79.09RVU24B
2024-03-09$239.20$79.09RVU24AR
2024-01-01$235.29$77.79RVU24A
2023-10-01$244.19$79.83RVU23D
2023-07-01$244.19$79.83RVU23C
2023-04-01$244.19$79.83RVU23B
2023-01-01$244.19$79.83RVU23A
2022-10-01$252.82$81.17RVU22D
2022-07-01$252.82$81.17RVU22C
2022-04-01$252.82$81.17RVU22B
2022-01-01$252.82$81.17RVU22A
2021-10-01$240.97$81.16RVU21D
2021-07-01$240.97$81.16RVU21C
2021-04-01$240.97$81.16RVU21B
2021-01-01$240.97$81.16RVU21A
2020-10-01$218.15$86.06RVU20D
2020-07-01$218.15$86.06RVU20C
2020-04-01$218.15$86.06RVU20B
2020-01-01$218.15$86.06RVU20A
2019-10-01$198.12$88.20RVU19D
2019-07-01$198.12$88.20RVU19C
2019-04-01$198.12$88.20RVU19B
2019-01-01$198.12$88.20RVU19A
2018-10-01$174.14$89.54RVU18D
2018-07-01$174.14$89.54RVU18C
2018-04-01$174.14$89.54RVU18B
2018-01-01$174.14$89.54RVU18AR1
2017-10-01$170.58$108.13RVU17D
2017-07-01$170.58$108.13RVU17C
2017-04-01$170.58$108.13RVU17B
2017-01-01$170.58$108.13RVU17A
2016-10-01$209.69$131.99RVU16D
2016-07-01$209.69$131.99RVU16C
2016-04-01$209.69$131.99RVU16B
2016-01-01$209.69$131.99RVU16A
2015-10-01$210.53$132.55RVU15D
2015-07-01$210.53$132.55RVU15C
2015-04-01$209.48$131.89RVU15B
2015-01-01$209.48$131.89RVU15A
2014-10-01$204.42$129.90RVU14D
2014-07-01$204.42$129.90RVU14C
2014-04-01$204.42$129.90RVU14B
2014-01-01$204.42$129.90RVU14A
2013-10-01$203.24$125.33RVU13D
2013-07-01$203.24$125.33RVU13C
2013-04-01$203.24$125.33RVU13B
2013-01-01$203.24$125.33RVU13AR

Price 52000 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

52000 billing questions

Can this code be billed with a cystoscopic bladder biopsy in the same session?

No. When the biopsy includes the diagnostic examination, report the applicable biopsy code rather than 52000.

Is an E/M visit separately billable on the day of an office cystoscopy?

Yes, if the clinician performs a significant, separately identifiable E/M service beyond routine same-day procedure care. The E/M service may concern the same condition; append modifier 25 to the E/M code.

Should modifier 50 be appended because both ureteral orifices are viewed?

No. Viewing both orifices is part of the examination, and the bilateral adjustment is inappropriate for 52000.

Does it matter whether a flexible or rigid cystoscope is used?

The code is the same for either scope type and for male or female patients. The site of service affects practice expense payment, not code selection.

What if the clinician also catheterizes a ureter for retrograde pyelography?

Report 52005 rather than 52000 for cystourethroscopy with ureteral catheterization. The diagnostic examination is included.

What documentation supports this code?

Record the indication, scope type, structures examined, and findings in the urethra and bladder. Document any additional procedure, since it may determine a different code.

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
RVUs for 52000PPRRVU2026_Oct_nonQPP.csv, line 6,105 (RVU26D)
Geographic factors for MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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