CPT code 52001: Clot evacuation, multiple obstructing clots2026 Medicare rate & RVUs in Guam
Reports cystoscopic irrigation and removal of multiple obstructing bladder clots, typically for gross hematuria causing clot retention or impaired bladder drainage.
Medicare pays $440.06 for 52001 in the office in Guam (Hawaii, Guam, HI). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 52001 covers
A urologist passes a cystoscope through the urethra into the bladder, then irrigates and evacuates multiple clots obstructing bladder drainage. The procedure is commonly performed in a hospital or other procedural setting for gross hematuria with clot retention, such as when clots prevent adequate emptying or catheter drainage. The code describes endoscopic clot removal, not simple catheter irrigation alone.
Report the service for the cystoscopic treatment of multiple obstructing clots; document the obstruction, endoscopic irrigation and evacuation, and clinical reason for intervention. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and 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.
52001 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | $440.06 | $250.56 |
How the 52001 rate is calculated
Each of 52001’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 · 52001
RVUs × geographic indexes × conversion factor
Work5.30
5.30 RVUs× 1.000 GPCI
Practice expense6.58
6.58 RVUs× 1.000 GPCI
Malpractice0.68
0.68 RVUs× 1.000 GPCI
Adjusted RVUs
12.5600
Conversion factor
$33.4009
Medicare rate
$419.52
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 52001
The CMS indicators that decide how 52001 is paid alongside other services.
CMS payment indicators · 52001
Clot evacuation, multiple obstructing clots
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
52001 without 51 · national office
$419.52
Clot evacuation, multiple obstructing clots
52001-51 · Second procedure: 50%
$209.76
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%).
52001 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 52000CystoscopyDiagnostic examination only
- 52000 represents cystourethroscopy without the clot-irrigation and evacuation service. Use 52001 when multiple obstructing clots are actively irrigated and evacuated.
- 51700Bladder irrigationSimple lavage or instillation
- 51700 describes bladder irrigation by instillation. It does not represent cystoscopic evacuation of multiple obstructing clots.
- 52005Ureteral catheterizationCystoscopic access
- 52005 includes ureteral catheterization during cystourethroscopy. It is not the code for evacuating multiple obstructing bladder clots.
52001 billing questions
When is 52001 more appropriate than diagnostic cystoscopy?
Use 52001 when cystoscopy includes irrigation and evacuation of multiple obstructing clots. A diagnostic examination without that clot treatment is a different service.
Can bladder irrigation by catheter be reported instead?
Simple irrigation through a catheter is distinct from cystoscopic evacuation of multiple obstructing clots. Select the service that matches the documented method and work performed.
Should 52001 be reported once for each clot?
No. The code represents the cystoscopic clot-evacuation procedure, not a separate unit for every clot removed.
How are related endoscopies priced when performed together?
CMS endoscopy-family pricing applies when related endoscopies are performed together. Document each distinct procedure performed during the session.
Can modifier 50 or an assistant-at-surgery claim be used?
No. Modifier 50 is inappropriate for this code, and Medicare does not pay an assistant at surgery for it.
Are co-surgeons or team surgery allowed?
CMS does not permit co-surgeons or team surgery for this service.
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.
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