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CPT code 52001: Clot evacuation, multiple obstructing clots2026 Medicare rate & RVUs in Puerto Rico

Reports cystoscopic irrigation and removal of multiple obstructing bladder clots, typically for gross hematuria causing clot retention or impaired bladder drainage.

CMS RVU26DEffective Oct 1, 2026One payment locality12.7K Medicare services in 2024

In Puerto Rico, Medicare pays $421.59 for 52001 in the office and $253.09 when it’s performed in a hospital or facility.

$421.59Office (non-facility)
$253.09Hospital or facility
+0.5%vs the national office rate ($419.52)

Check a contract rate as a % of Medicare · 52001 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 52001 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 52001 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 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.

How Puerto Rico compares for 52001

Across 109 of 109 payment localities, the office rate for 52001 runs from $377.51 in Arkansas to $525.59 in San Benito County, CA. Puerto Rico pays $421.59. The RVUs are the same everywhere; the geographic indexes change the dollars.

52001 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$421.59
  2. Los Angeles, CA · California$459.36+$37.77
  3. Washington, DC area · District of Columbia$470.76+$49.17
  4. Miami, FL · Florida$463.25+$41.66
  5. Chicago, IL · Illinois$451.27+$29.68
  6. Manhattan, NY · New York$479.76+$58.17
  7. Alaska · Alaska$512.12+$90.53

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

Every other payment area

52001 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$382.19$236.35
ArkansasArkansas$377.51$234.34
ArizonaArizona$409.43$247.93
Bakersfield, CACalifornia$435.10$252.43
Chico, CACalifornia$433.08$250.41
El Centro, CACalifornia$433.20$250.53
Fresno, CACalifornia$433.08$250.41
Hanford, CACalifornia$433.08$250.41

52001 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$377.51

$512.12

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

View every state and territory as a table
52001 office rate range by state
State / territoryOffice rate rangeLocalities
AK$512.121
AL$382.191
AR$377.511
AZ$409.431
CA$433.08–$525.5929
CO$430.731
CT$444.751
DC$470.761
DE$415.471
FL$421.27–$463.253
GA$400.14–$428.132
GU$440.061
HI$440.061
IA$387.141
ID$389.961
IL$413.18–$451.274
IN$391.801
KS$387.151
KY$393.191
LA$393.29–$409.642
MA$429.39–$466.912
MD$422.06–$470.763
ME$393.35–$409.162
MI$403.32–$427.402
MN$409.901
MO$388.60–$409.013
MS$383.041
MT$419.471
NC$396.591
ND$406.021
NE$388.471
NH$425.691
NJ$449.02–$467.382
NM$405.841
NV$415.941
NY$401.78–$491.855
OH$400.581
OK$390.931
OR$411.89–$440.932
PA$400.24–$436.102
PR$421.591
RI$427.681
SC$399.411
SD$404.431
TN$389.001
TX$398.12–$430.038
UT$404.011
VA$409.10–$470.762
VI$421.591
VT$406.101
WA$428.04–$474.102
WI$394.571
WV$400.511
WY$413.611

See 52001 in every payment locality

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

Office or facility?

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.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,106

Code
52001
Physician work
5.30
Practice expense
6.58
Malpractice
0.68

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 52001 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work5.30× 1.0005.3000
Practice expense6.58× 1.0116.6524
Malpractice0.68× 0.9850.6698
Total RVUs12.6222
Conversion factor× 33.4009

Office rate, Puerto Rico$421.59

Office: (5.3 × 1 + 6.58 × 1.011 + 0.68 × 0.985) × $33.4009 = $421.59

Facility: (5.3 × 1 + 1.59 × 1.011 + 0.68 × 0.985) × $33.4009 = $253.09

Open 52001 in the RVU calculator

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

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
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

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%).

When to use modifier 51

Codes related to 52001

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 52001
CodeHow it relatesOffice range, Puerto Rico
Same family
52000Cystoscopy, diagnostic examination onlyCystourethroscopy without the multiple-obstructing-clot evacuation described by 52001.$217.42
52005Ureteral catheterization, cystoscopic accessCystourethroscopy with ureteral catheterization, a different endoscopic service.$282.55
Used instead
51700Bladder irrigation, simple lavage or instillationBladder irrigation by instillation, rather than cystoscopic evacuation of obstructing clots.$78.74

How 52001 has changed in Puerto Rico

52001 · Office / nonfacility

$421.59

Effective 2026-10-01

The base rate is $13.25 higher than on 2025-10-01, moving from $408.34 to $421.59 (3.2%).

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

    $408.34changed to$421.59

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.44 changed to 5.30
    • Practice expense RVU 6.50 changed to 6.58
    • Malpractice RVU 0.65 changed to 0.68
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $438.97changed to$408.34

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.04 changed to 6.50
    • Malpractice RVU 0.67 changed to 0.65

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $431.80changed to$438.97

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $445.47changed to$431.80

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.01 changed to 7.04
    • Malpractice RVU 0.65 changed to 0.67
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $443.92changed to$445.47

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $457.41changed to$443.92

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.08 changed to 7.01
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $448.90changed to$457.41

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.74 changed to 7.08
    • Malpractice RVU 0.64 changed to 0.65

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $430.52changed to$448.90

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.83 changed to 6.74
    • Malpractice RVU 0.62 changed to 0.64
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $409.08changed to$430.52

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.28 changed to 5.83
    • Malpractice RVU 0.60 changed to 0.62
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $387.60changed to$409.08

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.70 changed to 5.28

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $350.91changed to$387.60

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.61 changed to 4.70
    • Malpractice RVU 0.61 changed to 0.60
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $315.77changed to$350.91

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.54 changed to 4.61
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $316.41changed to$315.77

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.52 changed to 4.54

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $314.83changed to$316.41

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $310.14changed to$314.83

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.45 changed to 4.52
    • Malpractice RVU 0.51 changed to 0.61
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $299.38changed to$310.14

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.76 changed to 4.45
    • Malpractice RVU 0.53 changed to 0.51
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $299.38

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$421.59$253.09RVU26D
2026-07-01$421.59$253.09RVU26C
2026-04-01$421.59$253.09RVU26B
2026-01-01$421.59$253.09RVU26A
2025-10-01$408.34$275.44RVU25D
2025-07-01$408.34$275.44RVU25C
2025-04-01$408.34$275.44RVU25B
2025-01-01$408.34$275.44RVU25A
2024-10-01$438.97$282.09RVU24D
2024-07-01$438.97$282.09RVU24C
2024-04-01$438.97$282.09RVU24B
2024-03-09$438.97$282.09RVU24AR
2024-01-01$431.80$277.49RVU24A
2023-10-01$445.47$284.24RVU23D
2023-07-01$443.92$283.97RVU23C
2023-04-01$443.92$283.97RVU23B
2023-01-01$443.92$283.97RVU23A
2022-10-01$457.41$288.23RVU22D
2022-07-01$457.41$288.23RVU22C
2022-04-01$457.41$288.23RVU22B
2022-01-01$457.41$288.23RVU22A
2021-10-01$448.90$290.62RVU21D
2021-07-01$448.90$290.62RVU21C
2021-04-01$448.90$290.62RVU21B
2021-01-01$448.90$290.62RVU21A
2020-10-01$430.52$298.83RVU20D
2020-07-01$430.52$298.83RVU20C
2020-04-01$430.52$298.83RVU20B
2020-01-01$430.52$298.83RVU20A
2019-10-01$409.08$299.84RVU19D
2019-07-01$409.08$299.84RVU19C
2019-04-01$409.08$299.84RVU19B
2019-01-01$409.08$299.84RVU19A
2018-10-01$387.60$300.60RVU18D
2018-07-01$387.60$300.60RVU18C
2018-04-01$387.60$300.60RVU18B
2018-01-01$387.60$300.60RVU18AR1
2017-10-01$350.91$279.03RVU17D
2017-07-01$350.91$279.03RVU17C
2017-04-01$350.91$279.03RVU17B
2017-01-01$350.91$279.03RVU17A
2016-10-01$315.77$257.46RVU16D
2016-07-01$315.77$257.46RVU16C
2016-04-01$315.77$257.46RVU16B
2016-01-01$315.77$257.46RVU16A
2015-10-01$316.41$258.39RVU15D
2015-07-01$316.41$258.39RVU15C
2015-04-01$314.83$257.11RVU15B
2015-01-01$314.83$257.11RVU15A
2014-10-01$310.14$254.86RVU14D
2014-07-01$310.14$254.86RVU14C
2014-04-01$310.14$254.86RVU14B
2014-01-01$310.14$254.86RVU14A
2013-10-01$299.38$243.09RVU13D
2013-07-01$299.38$243.09RVU13C
2013-04-01$299.38$243.09RVU13B
2013-01-01$299.38$243.09RVU13AR

Price 52001 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 52001PPRRVU2026_Oct_nonQPP.csv, line 6,106 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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