CPT code 52234: Bladder tumor treatment, tumor 0.5 to 2.0 cm2026 Medicare rate & RVUs in South Dakota

Report this service for cystoscopic treatment or removal of a bladder tumor measuring 0.5 to 2.0 cm, typically by a urologist.

CMS RVU26DEffective Oct 1, 2026One payment locality27.4K Medicare services in 2024

In South Dakota, Medicare pays $204.13 for 52234 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$204.13Hospital or facility

Check a contract rate as a % of Medicare · 52234 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 52234 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 52234 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 52234 covers

A urologist uses a cystoscope to access the bladder and treat or remove a tumor in the 0.5-to-2.0-cm size range. Treatment may involve resection or destruction of the lesion, including with electrocautery, laser, or cryosurgery. The service is commonly performed in an operating room or outpatient procedural setting for a patient with a bladder tumor identified during evaluation or surveillance.

Choose this level according to the documented tumor size; smaller and larger tumor levels are reported with their corresponding codes. The operative report should describe the lesion size and treatment performed. This is a minor procedure with 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 service, 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 South Dakota compares for 52234

Across 109 of 109 payment localities, the facility rate for 52234 runs from $200.85 in Arkansas to $286.46 in Alaska. South Dakota pays $204.13. The RVUs are the same everywhere; the geographic indexes change the dollars.

52234 in South Dakota vs other payment areas
  1. South Dakota · this page$204.13
  2. Los Angeles, CA · California$225.22+$21.09
  3. Washington, DC area · District of Columbia$235.48+$31.35
  4. Miami, FL · Florida$247.83+$43.70
  5. Chicago, IL · Illinois$242.72+$38.59
  6. Manhattan, NY · New York$245.23+$41.10
  7. Alaska · Alaska$286.46+$82.33

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

Every other payment area

52234 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$202.58
ArkansasArkansas—$200.85
ArizonaArizona—$212.56
Bakersfield, CACalifornia—$216.74
Chico, CACalifornia—$215.05
El Centro, CACalifornia—$215.14
Fresno, CACalifornia—$215.05
Hanford, CACalifornia—$215.05

52234 rates by state

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

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Local rates. Clear comparisons.

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

View every state and territory as a table
52234 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 52234 in every payment locality

How the 52234 rate is calculated

Each of 52234’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 · 52234

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.50

4.50 RVUs× 1.000 GPCI

Practice expense1.42

1.42 RVUs× 1.000 GPCI

Malpractice0.57

0.57 RVUs× 1.000 GPCI

Adjusted RVUs

6.4900

Conversion factor

$33.4009

Medicare rate

$216.77

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

6,114

Code
52234
Physician work
4.50
Practice expense
1.42
Malpractice
0.57

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Facility calculation for 52234 in South Dakota
ComponentRVULocality factorAdjusted
Physician work4.50× 1.0004.5000
Practice expense1.42× 1.0001.4200
Malpractice0.57× 0.3360.1915
Total RVUs6.1115
Conversion factor× 33.4009

Facility rate, South Dakota$204.13

Facility: (4.5 × 1 + 1.42 × 1 + 0.57 × 0.336) × $33.4009 = $204.13

Open 52234 in the RVU calculator

Payment rules and modifiers for 52234

The CMS indicators that decide how 52234 is paid alongside other services.

CMS payment indicators · 52234

Bladder tumor treatment, tumor 0.5 to 2.0 cm

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

52234 without 51 · national facility

$216.77

Bladder tumor treatment, tumor 0.5 to 2.0 cm

52234-51 · Second procedure: 50%

$108.39

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 52234 has changed in South Dakota

52234 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$204.13RVU26D
2026-07-01Not available in this setting$204.13RVU26C
2026-04-01Not available in this setting$204.13RVU26B
2026-01-01Not available in this setting$204.13RVU26A
2025-10-01Not available in this setting$224.93RVU25D
2025-07-01Not available in this setting$224.93RVU25C
2025-04-01Not available in this setting$224.93RVU25B
2025-01-01Not available in this setting$224.93RVU25A
2024-10-01Not available in this setting$229.81RVU24D
2024-07-01Not available in this setting$229.81RVU24C
2024-04-01Not available in this setting$229.81RVU24B
2024-03-09Not available in this setting$229.81RVU24AR
2024-01-01Not available in this setting$226.06RVU24A
2023-10-01Not available in this setting$231.46RVU23D
2023-07-01Not available in this setting$231.46RVU23C
2023-04-01Not available in this setting$231.46RVU23B
2023-01-01Not available in this setting$231.46RVU23A
2022-10-01Not available in this setting$234.09RVU22D
2022-07-01Not available in this setting$234.09RVU22C
2022-04-01Not available in this setting$234.09RVU22B
2022-01-01Not available in this setting$234.09RVU22A
2021-10-01Not available in this setting$236.01RVU21D
2021-07-01Not available in this setting$236.01RVU21C
2021-04-01Not available in this setting$236.01RVU21B
2021-01-01Not available in this setting$236.01RVU21A
2020-10-01Not available in this setting$243.43RVU20D
2020-07-01Not available in this setting$243.43RVU20C
2020-04-01Not available in this setting$243.43RVU20B
2020-01-01Not available in this setting$243.43RVU20A
2019-10-01Not available in this setting$245.37RVU19D
2019-07-01Not available in this setting$245.37RVU19C
2019-04-01Not available in this setting$245.37RVU19B
2019-01-01Not available in this setting$245.37RVU19A
2018-10-01Not available in this setting$246.18RVU18D
2018-07-01Not available in this setting$246.18RVU18C
2018-04-01Not available in this setting$246.18RVU18B
2018-01-01Not available in this setting$246.18RVU18AR1
2017-10-01Not available in this setting$244.60RVU17D
2017-07-01Not available in this setting$244.60RVU17C
2017-04-01Not available in this setting$244.60RVU17B
2017-01-01Not available in this setting$244.60RVU17A
2016-10-01Not available in this setting$242.68RVU16D
2016-07-01Not available in this setting$242.68RVU16C
2016-04-01Not available in this setting$242.68RVU16B
2016-01-01Not available in this setting$242.68RVU16A
2015-10-01Not available in this setting$243.41RVU15D
2015-07-01Not available in this setting$243.41RVU15C
2015-04-01Not available in this setting$242.20RVU15B
2015-01-01Not available in this setting$242.20RVU15A
2014-10-01Not available in this setting$241.26RVU14D
2014-07-01Not available in this setting$241.26RVU14C
2014-04-01Not available in this setting$241.26RVU14B
2014-01-01Not available in this setting$241.26RVU14A
2013-10-01Not available in this setting$232.72RVU13D
2013-07-01Not available in this setting$232.72RVU13C
2013-04-01Not available in this setting$232.72RVU13B
2013-01-01Not available in this setting$232.72RVU13AR

Price 52234 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

52234 billing questions

How is 52234 distinguished from 52224 or 52235?

52234 is for a bladder tumor measuring 0.5 to 2.0 cm. Use the neighboring tumor-treatment level when the documented size falls into that code’s size category.

When would 52204 be considered instead?

52204 describes cystoscopy with biopsy. Code 52234 represents cystoscopic treatment or removal of a bladder tumor in its size range; submitting tissue for pathology during treatment does not by itself establish a separate biopsy service.

Is modifier 50 appropriate for tumors on both sides of the bladder?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

Are same-day preoperative and postoperative visits included?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be paid for this procedure?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

What happens when related endoscopies are performed during the same session?

CMS endoscopy-family pricing applies when related endoscopies are performed together. Review the other endoscopic services against that family pricing rule.

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 52234PPRRVU2026_Oct_nonQPP.csv, line 6,114 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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