CPT code 52276: Urethral stricture treatment, direct-vision incision2026 Medicare rate & RVUs in Michigan
Reports endoscopic incision of a urethral stricture under direct vision, typically when a urologist treats scar-related narrowing of the urethral lumen.
CMS doesn’t publish an office rate for 52276 in Michigan.
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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What 52276 covers
A urologist passes a cystourethroscope through the urethra and directly visualizes a scarred, narrowed segment before incising it to open the lumen. This procedure is commonly performed in a hospital outpatient department or ambulatory surgery center for urethral stricture disease; the operative report should identify the stricture and describe the incision performed.
Select 52276 when the surgeon treats the narrowing by incision under direct vision, rather than by dilation alone or a meatotomy for narrowing at the urethral opening. Document the stricture location, endoscopic findings, and technique. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, 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.
Where 52276 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | $245.92 |
| Rest of Michigan | Unavailable | $231.78 |
How the 52276 rate is calculated
Each of 52276’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 · 52276
RVUs × geographic indexes × conversion factor
Work4.87
4.87 RVUs× 1.000 GPCI
Practice expense1.50
1.50 RVUs× 1.000 GPCI
Malpractice0.62
0.62 RVUs× 1.000 GPCI
Adjusted RVUs
6.9900
Conversion factor
$33.4009
Medicare rate
$233.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 52276
The CMS indicators that decide how 52276 is paid alongside other services.
CMS payment indicators · 52276
Urethral stricture treatment, direct-vision incision
| 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
52276 without 51 · national facility
$233.47
Urethral stricture treatment, direct-vision incision
52276-51 · Second procedure: 50%
$116.74
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%).
52276 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 52281Urethral dilationCystoscopic stricture treatment
- Choose 52276 for direct-vision incision of a urethral stricture. Choose 52281 for cystourethroscopic calibration and/or dilation.
- 52284Urethral dilationDrug-coated balloon
- 52276 identifies direct-vision internal incision; 52284 represents a distinct mechanical approach to treating urethral narrowing. Base selection on the documented technique.
- 52270UrethrotomyFemale urethra
- 52270 is a urethral meatotomy procedure. Use 52276 when the operative service is incision of a urethral stricture under direct vision.
52276 billing questions
When is 52276 preferable to 52281?
Use 52276 when the surgeon incises the urethral stricture under direct vision. Code 52281 is for cystourethroscopic calibration and/or dilation of a stricture or stenosis.
How does 52276 differ from 52284?
Both address urethral narrowing, but 52276 describes direct-vision internal incision. Review the operative technique to determine whether the service fits 52284’s distinct mechanical treatment approach.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inapplicable because the descriptor or anatomy makes modifier 50 inappropriate.
What same-day care is included?
The 0-day global period includes preoperative and postoperative care on the procedure date. Related endoscopies performed together are subject to CMS endoscopy-family pricing.
Can an assistant or co-surgeon be paid?
CMS restricts assistant-at-surgery payment for this code. 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
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