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

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 Vermont, Medicare pays $336.08 for 52265 in the office and $137.02 when it’s performed in a hospital or facility.

$336.08Office (non-facility)
$137.02Hospital 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 Vermont
  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 Vermont 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. Vermont pays $336.08. The RVUs are the same everywhere; the geographic indexes change the dollars.

52265 in Vermont vs other payment areas
  1. Vermont · this page$336.08
  2. Los Angeles, CA · California$387.67+$51.59
  3. Washington, DC area · District of Columbia$394.04+$57.96
  4. Miami, FL · Florida$376.47+$40.39
  5. Chicago, IL · Illinois$365.38+$29.30
  6. Manhattan, NY · New York$397.87+$61.79
  7. Alaska · Alaska$402.30+$66.22

Other areas in Vermont 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.

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.

$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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 52265 in Vermont
ComponentRVULocality factorAdjusted
Physician work2.87× 1.0002.8700
Practice expense7.05× 0.9906.9795
Malpractice0.42× 0.5060.2125
Total RVUs10.0620
Conversion factor× 33.4009

Office rate, Vermont$336.08

Office: (2.87 × 1 + 7.05 × 0.99 + 0.42 × 0.506) × $33.4009 = $336.08

Facility: (2.87 × 1 + 1.03 × 0.99 + 0.42 × 0.506) × $33.4009 = $137.02

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

Codes related to 52265

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

Codes related to 52265
CodeHow it relatesOffice range, Vermont
Used instead
52214Cystoscopy treatment, fulguration at specified sitesCystoscopic fulguration for specified sites such as the trigone or bladder neck, rather than female urethral syndrome.$714.38
52224Bladder lesion treatment, lesions under 0.5 cmCystoscopic treatment of minor bladder lesion(s), distinguished by the bladder target and lesion size.$746.00
52204Cystoscopic biopsy, bladder tissue samplingCystoscopic biopsy when tissue sampling, rather than fulguration for female urethral syndrome, is performed.$347.18
52260Bladder distention, general or spinal anesthesiaCystoscopic bladder dilation for interstitial cystitis, a different treatment and indication.No office rate

How 52265 has changed in Vermont

52265 · Office / nonfacility

$336.08

Effective 2026-10-01

The base rate is $5.58 higher than on 2025-10-01, moving from $330.50 to $336.08 (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

    $330.50changed to$336.08

    • 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
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $363.58changed to$330.50

    • 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

    $357.64changed to$363.58

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $374.20changed to$357.64

    • 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
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518

  5. January 1, 2023

    RVU23A

    $388.63changed to$374.20

    • 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
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $396.19changed to$388.63

    • 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

    $388.22changed to$396.19

    • 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
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $382.26changed to$388.22

    • 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
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $376.51changed to$382.26

    • 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

    $371.53changed to$376.51

    • 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
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $368.08changed to$371.53

    • 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
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $369.04changed to$368.08

    • 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

    $367.21changed to$369.04

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $362.37changed to$367.21

    • 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
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$362.37

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$336.08$137.02RVU26D
2026-07-01$336.08$137.02RVU26C
2026-04-01$336.08$137.02RVU26B
2026-01-01$336.08$137.02RVU26A
2025-10-01$330.50$149.98RVU25D
2025-07-01$330.50$149.98RVU25C
2025-04-01$330.50$149.98RVU25B
2025-01-01$330.50$149.98RVU25A
2024-10-01$363.58$153.35RVU24D
2024-07-01$363.58$153.35RVU24C
2024-04-01$363.58$153.35RVU24B
2024-03-09$363.58$153.35RVU24AR
2024-01-01$357.64$150.85RVU24A
2023-10-01$374.20$155.27RVU23D
2023-07-01$374.20$155.27RVU23C
2023-04-01$374.20$155.27RVU23B
2023-01-01$374.20$155.27RVU23A
2022-10-01$388.63$157.57RVU22D
2022-07-01$388.63$157.57RVU22C
2022-04-01$388.63$157.57RVU22B
2022-01-01$388.63$157.57RVU22A
2021-10-01$396.19$159.03RVU21D
2021-07-01$396.19$159.03RVU21C
2021-04-01$396.19$159.03RVU21B
2021-01-01$396.19$159.03RVU21A
2020-10-01$388.22$164.13RVU20D
2020-07-01$388.22$164.13RVU20C
2020-04-01$388.22$164.13RVU20B
2020-01-01$388.22$164.13RVU20A
2019-10-01$382.26$164.24RVU19D
2019-07-01$382.26$164.24RVU19C
2019-04-01$382.26$164.24RVU19B
2019-01-01$382.26$164.24RVU19A
2018-10-01$376.51$164.94RVU18D
2018-07-01$376.51$164.94RVU18C
2018-04-01$376.51$164.94RVU18B
2018-01-01$376.51$164.94RVU18AR1
2017-10-01$371.53$164.91RVU17D
2017-07-01$371.53$164.91RVU17C
2017-04-01$371.53$164.91RVU17B
2017-01-01$371.53$164.91RVU17A
2016-10-01$368.08$164.25RVU16D
2016-07-01$368.08$164.25RVU16C
2016-04-01$368.08$164.25RVU16B
2016-01-01$368.08$164.25RVU16A
2015-10-01$369.04$164.48RVU15D
2015-07-01$369.04$164.48RVU15C
2015-04-01$367.21$163.67RVU15B
2015-01-01$367.21$163.67RVU15A
2014-10-01$362.37$163.44RVU14D
2014-07-01$362.37$163.44RVU14C
2014-04-01$362.37$163.44RVU14B
2014-01-01$362.37$163.44RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 52265 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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 VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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