CPT code 52265: Urethral fulguration, female urethral syndrome2026 Medicare rate & RVUs in Texas
Report cystoscopic fulguration when a urologist treats tissue associated with female urethral syndrome using cautery, laser, or cryosurgery.
Medicare pays $323.18–$357.62 for 52265 in the office in Texas, from Beaumont, TX to Austin, TX. 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 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.
Where 52265 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$323.18 to $357.62
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $357.62 | $144.88 |
| Beaumont, TX | $323.18 | $140.20 |
| Brazoria, TX | $340.93 | $141.66 |
| Dallas, TX | $343.29 | $143.02 |
| Fort Worth, TX | $341.12 | $142.86 |
| Galveston, TX | $342.07 | $142.41 |
| Houston, TX | $349.76 | $150.09 |
| Rest of Texas | $332.00 | $141.18 |
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
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.
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
| 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
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%).
52265 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 52214Cystoscopy treatmentFulguration at specified sites
- Choose 52265 for fulguration associated with female urethral syndrome. Choose 52214 when fulguration targets the specified sites such as the trigone, bladder neck, prostatic fossa, urethra, or periurethral glands.
- 52224Bladder lesion treatmentLesions under 0.5 cm
- 52224 is for cystoscopic fulguration of minor bladder lesion(s). 52265 is tied to female urethral syndrome, not the size-based treatment of bladder lesions.
- 52204Cystoscopic biopsyBladder tissue sampling
- 52204 reports cystoscopic biopsy. Fulguration associated with female urethral syndrome is the defining service for 52265; use the code that reflects the documented procedure.
- 52260Bladder distentionGeneral or spinal anesthesia
- 52260 describes bladder dilation for interstitial cystitis. It is not the cystoscopic fulguration service for female urethral syndrome reported with 52265.
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
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