CPT code 52007: Ureteral biopsy, brush biopsy by catheter2026 Medicare rate & RVUs in South Dakota

Cystoscopic ureteral catheterization with brush sampling of a ureter or renal pelvis, typically used to evaluate a suspected upper urinary tract lesion.

CMS RVU26DEffective Oct 1, 2026One payment locality167 Medicare services in 2024

In South Dakota, Medicare pays $422.67 for 52007 in the office and $139.09 when it’s performed in a hospital or facility.

$422.67Office (non-facility)
$139.09Hospital or facility
−2.1%vs the national office rate ($431.54)

Check a contract rate as a % of Medicare · 52007 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 52007 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 52007 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 52007 covers

A urologist passes a cystoscope through the urethra into the bladder, advances a catheter into a ureter, and obtains a brush sample from the ureter or renal pelvis. The service is used when evaluation of a suspected upper-tract urothelial abnormality calls for brush sampling rather than tissue biopsy under direct ureteroscopic vision. It is typically performed in an operating room or procedure suite, with the specimen sent for pathologic evaluation.

Report the service for the catheter-directed brush biopsy, documenting the sampled site, laterality, clinical reason, and procedure performed. Routine cystoscopic access and ureteral catheterization for the brush sampling are included; do not separately report those steps for the same service. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy-family pricing applies. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery services are subject to a statutory payment restriction; 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 South Dakota compares for 52007

Across 109 of 109 payment localities, the office rate for 52007 runs from $379.94 in Arkansas to $577.57 in San Benito County, CA. South Dakota pays $422.67. The RVUs are the same everywhere; the geographic indexes change the dollars.

52007 in South Dakota vs other payment areas
  1. South Dakota · this page$422.67
  2. Los Angeles, CA · California$489.63+$66.96
  3. Washington, DC area · District of Columbia$495.31+$72.64
  4. Miami, FL · Florida$465.09+$42.42
  5. Chicago, IL · Illinois$451.13+$28.46
  6. Manhattan, NY · New York$497.49+$74.82
  7. Alaska · Alaska$495.44+$72.77

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

Every other payment area

52007 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$385.74$137.62
ArkansasArkansas$379.94$136.35
ArizonaArizona$419.70$144.91
Bakersfield, CACalifornia$458.90$148.10
Chico, CACalifornia$457.73$146.93
El Centro, CACalifornia$457.79$147.00
Fresno, CACalifornia$457.73$146.93
Hanford, CACalifornia$457.73$146.93

52007 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.

$379.94

$517.65

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

View every state and territory as a table
52007 office rate range by state
State / territoryOffice rate rangeLocalities
AK$495.441
AL$385.741
AR$379.941
AZ$419.701
CA$457.73–$577.5729
CO$450.271
CT$460.951
DC$495.311
DE$426.841
FL$424.18–$465.093
GA$399.55–$439.642
GU$469.751
HI$469.751
IA$396.281
ID$398.901
IL$411.22–$451.184
IN$401.311
KS$394.191
KY$394.891
LA$394.18–$414.482
MA$447.36–$496.172
MD$435.27–$495.313
ME$400.89–$423.732
MI$405.42–$429.512
MN$431.411
MO$387.03–$416.213
MS$383.581
MT$431.511
NC$405.281
ND$423.601
NE$398.591
NH$442.991
NJ$466.20–$489.832
NM$407.671
NV$429.631
NY$411.57–$509.755
OH$403.811
OK$394.321
OR$426.29–$465.212
PA$404.57–$449.002
PR$434.861
RI$442.521
SC$405.221
SD$422.671
TN$396.241
TX$401.79–$448.778
UT$410.981
VA$422.17–$495.312
VI$434.861
VT$421.741
WA$446.58–$506.642
WI$408.861
WV$395.381
WY$428.071

See 52007 in every payment locality

How the 52007 rate is calculated

Each of 52007’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 · 52007

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.94

2.94 RVUs× 1.000 GPCI

Practice expense9.58

9.58 RVUs× 1.000 GPCI

Malpractice0.40

0.40 RVUs× 1.000 GPCI

Adjusted RVUs

12.9200

Conversion factor

$33.4009

Medicare rate

$431.54

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

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,108

Code
52007
Physician work
2.94
Practice expense
9.58
Malpractice
0.40

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 52007 in South Dakota
ComponentRVULocality factorAdjusted
Physician work2.94× 1.0002.9400
Practice expense9.58× 1.0009.5800
Malpractice0.40× 0.3360.1344
Total RVUs12.6544
Conversion factor× 33.4009

Office rate, South Dakota$422.67

Office: (2.94 × 1 + 9.58 × 1 + 0.4 × 0.336) × $33.4009 = $422.67

Facility: (2.94 × 1 + 1.09 × 1 + 0.4 × 0.336) × $33.4009 = $139.09

Open 52007 in the RVU calculator

Payment rules and modifiers for 52007

The CMS indicators that decide how 52007 is paid alongside other services.

CMS payment indicators · 52007

Ureteral biopsy, brush biopsy by catheter

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 50 · payment effect

With and without the modifier

52007 without 50 · national office

$431.54

Ureteral biopsy, brush biopsy by catheter

52007-50 · Bilateral: 150%

$647.31

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

How 52007 has changed in South Dakota

52007 · Office / nonfacility

$422.67

Effective 2026-10-01

The base rate is $18.70 higher than on 2025-10-01, moving from $403.97 to $422.67 (4.6%).

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

    $403.97changed to$422.67

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.02 changed to 2.94
    • Practice expense RVU 9.32 changed to 9.58
    • Malpractice RVU 0.39 changed to 0.40
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $440.36changed to$403.97

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.06 changed to 9.32

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $433.17changed to$440.36

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $451.87changed to$433.17

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.18 changed to 10.06
    • Malpractice RVU 0.37 changed to 0.39
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $467.82changed to$451.87

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.37 changed to 10.18
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $486.93changed to$467.82

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.81 changed to 10.37
    • Malpractice RVU 0.36 changed to 0.37

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $479.59changed to$486.93

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.14 changed to 10.81
    • Malpractice RVU 0.35 changed to 0.36
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $467.51changed to$479.59

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.82 changed to 10.14
    • Malpractice RVU 0.34 changed to 0.35
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $453.18changed to$467.51

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.44 changed to 9.82
    • Malpractice RVU 0.33 changed to 0.34

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $445.89changed to$453.18

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.27 changed to 9.44
    • Malpractice RVU 0.34 changed to 0.33
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $441.68changed to$445.89

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.18 changed to 9.27
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $442.92changed to$441.68

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.17 changed to 9.18

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $440.71changed to$442.92

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $434.55changed to$440.71

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.99 changed to 9.17
    • Malpractice RVU 0.29 changed to 0.34
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $440.58changed to$434.55

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.80 changed to 8.99
    • Malpractice RVU 0.30 changed to 0.29
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $440.58

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$422.67$139.09RVU26D
2026-07-01$422.67$139.09RVU26C
2026-04-01$422.67$139.09RVU26B
2026-01-01$422.67$139.09RVU26A
2025-10-01$403.97$152.64RVU25D
2025-07-01$403.97$152.64RVU25C
2025-04-01$403.97$152.64RVU25B
2025-01-01$403.97$152.64RVU25A
2024-10-01$440.36$155.75RVU24D
2024-07-01$440.36$155.75RVU24C
2024-04-01$440.36$155.75RVU24B
2024-03-09$440.36$155.75RVU24AR
2024-01-01$433.17$153.21RVU24A
2023-10-01$451.87$156.38RVU23D
2023-07-01$451.87$156.38RVU23C
2023-04-01$451.87$156.38RVU23B
2023-01-01$451.87$156.38RVU23A
2022-10-01$467.82$157.75RVU22D
2022-07-01$467.82$157.75RVU22C
2022-04-01$467.82$157.75RVU22B
2022-01-01$467.82$157.75RVU22A
2021-10-01$486.93$159.28RVU21D
2021-07-01$486.93$159.28RVU21C
2021-04-01$486.93$159.28RVU21B
2021-01-01$486.93$159.28RVU21A
2020-10-01$479.59$163.80RVU20D
2020-07-01$479.59$163.80RVU20C
2020-04-01$479.59$163.80RVU20B
2020-01-01$479.59$163.80RVU20A
2019-10-01$467.51$165.50RVU19D
2019-07-01$467.51$165.50RVU19C
2019-04-01$467.51$165.50RVU19B
2019-01-01$467.51$165.50RVU19A
2018-10-01$453.18$165.54RVU18D
2018-07-01$453.18$165.54RVU18C
2018-04-01$453.18$165.54RVU18B
2018-01-01$453.18$165.54RVU18AR1
2017-10-01$445.89$164.88RVU17D
2017-07-01$445.89$164.88RVU17C
2017-04-01$445.89$164.88RVU17B
2017-01-01$445.89$164.88RVU17A
2016-10-01$441.68$163.48RVU16D
2016-07-01$441.68$163.48RVU16C
2016-04-01$441.68$163.48RVU16B
2016-01-01$441.68$163.48RVU16A
2015-10-01$442.92$164.07RVU15D
2015-07-01$442.92$164.07RVU15C
2015-04-01$440.71$163.26RVU15B
2015-01-01$440.71$163.26RVU15A
2014-10-01$434.55$163.02RVU14D
2014-07-01$434.55$163.02RVU14C
2014-04-01$434.55$163.02RVU14B
2014-01-01$434.55$163.02RVU14A
2013-10-01$440.58$157.51RVU13D
2013-07-01$440.58$157.51RVU13C
2013-04-01$440.58$157.51RVU13B
2013-01-01$440.58$157.51RVU13AR

Price 52007 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

52007 billing questions

When should 52007 be chosen instead of 52005?

Use 52007 when a brush biopsy is taken from the ureter or renal pelvis through a ureteral catheter. Code 52005 describes ureteral catheterization without that brush-biopsy service.

Can cystoscopy or ureteral catheterization be billed separately?

Routine cystoscopic access and catheterization used to obtain the brush sample are included in 52007. Do not separately report 52000 or 52005 for those same steps.

How is a bilateral brush biopsy reported?

CMS identifies 52007 as a bilateral procedure; modifier 50 is paid at 150%. Document which ureters or renal pelvis sites were sampled.

How does 52007 differ from 52354?

52007 involves brush sampling through a ureteral catheter. Code 52354 is used for biopsy performed during ureteroscopy or pyeloscopy, rather than catheter-directed brush sampling.

Are same-day related endoscopies paid independently?

CMS applies endoscopy-family pricing when related endoscopies are performed together. The service also has a 0-day global period, which includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be reported?

CMS does not pay an assistant at surgery for this service under the stated statutory restriction. Co-surgeons and team surgery are 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
RVUs for 52007PPRRVU2026_Oct_nonQPP.csv, line 6,108 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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