CPT code 52265: Urethral fulguration, female urethral syndrome2026 Medicare rate & RVUs in South Dakota

Report cystoscopic fulguration when a urologist treats tissue associated with female urethral syndrome using cautery, laser, or cryosurgery.

CMS RVU26DEffective Oct 1, 2026One payment locality887 Medicare services in 2024

In South Dakota, Medicare pays $336.05 for 52265 in the office and $134.98 when it’s performed in a hospital or facility.

$336.05Office (non-facility)
$134.98Hospital or facility
−2.7%vs the national office rate ($345.37)

Check a contract rate as a % of Medicare · 52265 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 52265 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 52265 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 52265 covers

A urologist passes a cystoscope through the urethra to examine and destroy targeted tissue associated with female urethral syndrome. Fulguration may use cautery, laser, or cryosurgery. The service is distinct from a diagnostic cystoscopy alone and from treatment directed at bladder lesions or other specifically named sites. It is typically performed in an outpatient setting, including an office or a procedure facility.

Report the service when the operative documentation supports the female urethral syndrome indication and identifies the treated tissue and method. The CMS global period is zero days, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies; payment should not be assumed to accrue independently for each procedure. Modifier 50 is inappropriate. Medicare does not pay for an assistant at surgery, and co-surgeons and team surgery are not permitted for this code.

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 52265

Across 109 of 109 payment localities, the office rate for 52265 runs from $305.36 in Arkansas to $453.48 in San Benito County, CA. South Dakota pays $336.05. The RVUs are the same everywhere; the geographic indexes change the dollars.

52265 in South Dakota vs other payment areas
  1. South Dakota · this page$336.05
  2. Los Angeles, CA · California$387.67+$51.62
  3. Washington, DC area · District of Columbia$394.04+$57.99
  4. Miami, FL · Florida$376.47+$40.42
  5. Chicago, IL · Illinois$365.38+$29.33
  6. Manhattan, NY · New York$397.87+$61.82
  7. Alaska · Alaska$402.30+$66.25

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

Every other payment area

52265 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$309.84$133.90
ArkansasArkansas$305.36$132.64
ArizonaArizona$336.05$141.21
Bakersfield, CACalifornia$364.31$143.93
Chico, CACalifornia$363.09$142.72
El Centro, CACalifornia$363.16$142.79
Fresno, CACalifornia$363.09$142.72
Hanford, CACalifornia$363.09$142.72

52265 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.

$305.36

$408.28

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

View every state and territory as a table
52265 office rate range by state
State / territoryOffice rate rangeLocalities
AK$402.301
AL$309.841
AR$305.361
AZ$336.051
CA$363.09–$453.4829
CO$358.511
CT$368.361
DC$394.041
DE$341.601
FL$342.06–$376.473
GA$322.63–$352.242
GU$371.721
HI$371.721
IA$316.891
ID$319.131
IL$332.78–$365.384
IN$320.961
KS$315.801
KY$318.041
LA$317.70–$333.382
MA$356.53–$393.432
MD$348.00–$394.043
ME$321.22–$338.072
MI$326.69–$346.752
MN$342.321
MO$312.50–$334.093
MS$308.971
MT$345.341
NC$324.521
ND$337.031
NE$318.511
NH$353.271
NJ$372.22–$390.032
NM$328.641
NV$343.261
NY$329.43–$408.035
OH$324.991
OK$317.041
OR$340.26–$369.452
PA$325.28–$359.452
PR$347.751
RI$353.441
SC$325.361
SD$336.051
TN$317.441
TX$323.18–$357.628
UT$329.811
VA$337.24–$394.042
VI$347.751
VT$336.081
WA$355.74–$401.042
WI$325.771
WV$320.561
WY$341.721

See 52265 in every payment locality

How the 52265 rate is calculated

Each of 52265’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 · 52265

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.87

2.87 RVUs× 1.000 GPCI

Practice expense7.05

7.05 RVUs× 1.000 GPCI

Malpractice0.42

0.42 RVUs× 1.000 GPCI

Adjusted RVUs

10.3400

Conversion factor

$33.4009

Medicare rate

$345.37

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

6,119

Code
52265
Physician work
2.87
Practice expense
7.05
Malpractice
0.42

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 52265 in South Dakota
ComponentRVULocality factorAdjusted
Physician work2.87× 1.0002.8700
Practice expense7.05× 1.0007.0500
Malpractice0.42× 0.3360.1411
Total RVUs10.0611
Conversion factor× 33.4009

Office rate, South Dakota$336.05

Office: (2.87 × 1 + 7.05 × 1 + 0.42 × 0.336) × $33.4009 = $336.05

Facility: (2.87 × 1 + 1.03 × 1 + 0.42 × 0.336) × $33.4009 = $134.98

Open 52265 in the RVU calculator

Payment rules and modifiers for 52265

The CMS indicators that decide how 52265 is paid alongside other services.

CMS payment indicators · 52265

Urethral fulguration, female urethral syndrome

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

52265 without 51 · national office

$345.37

Urethral fulguration, female urethral syndrome

52265-51 · Second procedure: 50%

$172.69

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 52265 has changed in South Dakota

52265 · Office / nonfacility

$336.05

Effective 2026-10-01

The base rate is $5.70 higher than on 2025-10-01, moving from $330.35 to $336.05 (1.7%).

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

    $330.35changed to$336.05

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.94 changed to 2.87
    • Practice expense RVU 7.12 changed to 7.05
    • Malpractice RVU 0.40 changed to 0.42
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $363.59changed to$330.35

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.83 changed to 7.12

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $357.66changed to$363.59

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $372.70changed to$357.66

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.92 changed to 7.83
    • Malpractice RVU 0.38 changed to 0.40
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $385.35changed to$372.70

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.06 changed to 7.92
    • Malpractice RVU 0.39 changed to 0.38
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $392.96changed to$385.35

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.19 changed to 8.06
    • Malpractice RVU 0.38 changed to 0.39

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $383.04changed to$392.96

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.53 changed to 8.19
    • Malpractice RVU 0.39 changed to 0.38
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $375.83changed to$383.04

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.36 changed to 7.53
    • Malpractice RVU 0.33 changed to 0.39
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $370.24changed to$375.83

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.22 changed to 7.36
    • Malpractice RVU 0.32 changed to 0.33

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $366.08changed to$370.24

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.13 changed to 7.22
    • Malpractice RVU 0.33 changed to 0.32
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $363.63changed to$366.08

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.08 changed to 7.13
    • Malpractice RVU 0.34 changed to 0.33
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $364.58changed to$363.63

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.07 changed to 7.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $362.77changed to$364.58

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $358.49changed to$362.77

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.93 changed to 7.07
    • Malpractice RVU 0.33 changed to 0.34
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $362.73changed to$358.49

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.57 changed to 6.93
    • Malpractice RVU 0.35 changed to 0.33
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $362.73

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$336.05$134.98RVU26D
2026-07-01$336.05$134.98RVU26C
2026-04-01$336.05$134.98RVU26B
2026-01-01$336.05$134.98RVU26A
2025-10-01$330.35$148.56RVU25D
2025-07-01$330.35$148.56RVU25C
2025-04-01$330.35$148.56RVU25B
2025-01-01$330.35$148.56RVU25A
2024-10-01$363.59$151.88RVU24D
2024-07-01$363.59$151.88RVU24C
2024-04-01$363.59$151.88RVU24B
2024-03-09$363.59$151.88RVU24AR
2024-01-01$357.66$149.41RVU24A
2023-10-01$372.70$153.11RVU23D
2023-07-01$372.70$153.11RVU23C
2023-04-01$372.70$153.11RVU23B
2023-01-01$372.70$153.11RVU23A
2022-10-01$385.35$154.53RVU22D
2022-07-01$385.35$154.53RVU22C
2022-04-01$385.35$154.53RVU22B
2022-01-01$385.35$154.53RVU22A
2021-10-01$392.96$156.04RVU21D
2021-07-01$392.96$156.04RVU21C
2021-04-01$392.96$156.04RVU21B
2021-01-01$392.96$156.04RVU21A
2020-10-01$383.04$160.73RVU20D
2020-07-01$383.04$160.73RVU20C
2020-04-01$383.04$160.73RVU20B
2020-01-01$383.04$160.73RVU20A
2019-10-01$375.83$161.04RVU19D
2019-07-01$375.83$161.04RVU19C
2019-04-01$375.83$161.04RVU19B
2019-01-01$375.83$161.04RVU19A
2018-10-01$370.24$161.80RVU18D
2018-07-01$370.24$161.80RVU18C
2018-04-01$370.24$161.80RVU18B
2018-01-01$370.24$161.80RVU18AR1
2017-10-01$366.08$161.51RVU17D
2017-07-01$366.08$161.51RVU17C
2017-04-01$366.08$161.51RVU17B
2017-01-01$366.08$161.51RVU17A
2016-10-01$363.63$160.62RVU16D
2016-07-01$363.63$160.62RVU16C
2016-04-01$363.63$160.62RVU16B
2016-01-01$363.63$160.62RVU16A
2015-10-01$364.58$160.84RVU15D
2015-07-01$364.58$160.84RVU15C
2015-04-01$362.77$160.04RVU15B
2015-01-01$362.77$160.04RVU15A
2014-10-01$358.49$160.75RVU14D
2014-07-01$358.49$160.75RVU14C
2014-04-01$358.49$160.75RVU14B
2014-01-01$358.49$160.75RVU14A
2013-10-01$362.73$155.87RVU13D
2013-07-01$362.73$155.87RVU13C
2013-04-01$362.73$155.87RVU13B
2013-01-01$362.73$155.87RVU13AR

Price 52265 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

52265 billing questions

How is 52265 distinguished from 52214?

52265 is for cystoscopic fulguration associated with female urethral syndrome. 52214 is used for fulguration of its specified anatomic sites, such as the trigone or bladder neck.

Is diagnostic cystoscopy separately reported with 52265?

The cystoscopic examination used to perform the fulguration is part of the service. The record should show the indication and what tissue was treated, rather than only a diagnostic examination.

Can modifier 50 be appended?

No. CMS identifies bilateral adjustment as inappropriate for this code because the descriptor or anatomy makes modifier 50 unsuitable.

How does CMS price 52265 with another endoscopy?

When related endoscopies are performed together, CMS endoscopy-family pricing applies. Payment is not simply assumed to be independent for each endoscopic service.

What surgical-assistance claims are permitted?

Medicare does not pay an assistant at surgery for 52265. Co-surgeons and team surgery are also 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 52265PPRRVU2026_Oct_nonQPP.csv, line 6,119 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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