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CPT code 52281: Urethral dilation, cystoscopic stricture treatment2026 Medicare rate & RVUs in Puerto Rico

Cystoscopic dilation widens a urethral narrowing, with or without meatotomy, when a urologist treats obstructive symptoms from stricture or stenosis.

CMS RVU26DEffective Oct 1, 2026One payment locality47.9K Medicare services in 2024

In Puerto Rico, Medicare pays $312.41 for 52281 in the office and $136.82 when it’s performed in a hospital or facility.

$312.41Office (non-facility)
$136.82Hospital or facility
+0.7%vs the national office rate ($310.29)

Check a contract rate as a % of Medicare · 52281 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 52281 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 52281 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 52281 covers

A urologist uses a cystoscope to evaluate a narrowed urethral segment and calibrate or widen it with suitable dilators. The procedure may also include a meatotomy when the narrowing involves the urethral opening. It is performed for urethral stricture or stenosis associated with symptoms such as impaired urinary flow, in an office or facility setting depending on the clinical circumstances and resources.

Report this code when the documented treatment is cystoscopic calibration or dilation of a urethral narrowing, whether or not meatotomy is performed. The record should identify the stricture or stenosis, its location when known, the treatment performed, and any meatotomy. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS applies endoscopy-family pricing. Report a single procedure rather than modifier 50; the descriptor and anatomy do not support bilateral reporting. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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 Puerto Rico compares for 52281

Across 109 of 109 payment localities, the office rate for 52281 runs from $275.03 in Arkansas to $406.83 in San Benito County, CA. Puerto Rico pays $312.41. The RVUs are the same everywhere; the geographic indexes change the dollars.

52281 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$312.41
  2. Los Angeles, CA · California$348.13+$35.72
  3. Washington, DC area · District of Columbia$353.65+$41.24
  4. Miami, FL · Florida$337.24+$24.83
  5. Chicago, IL · Illinois$327.54+$15.13
  6. Manhattan, NY · New York$356.89+$44.48
  7. Alaska · Alaska$363.22+$50.81

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

52281 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$278.98$127.01
ArkansasArkansas$275.03$125.83
ArizonaArizona$302.09$133.79
Bakersfield, CACalifornia$327.33$136.98
Chico, CACalifornia$326.28$135.92
El Centro, CACalifornia$326.34$135.98
Fresno, CACalifornia$326.28$135.92
Hanford, CACalifornia$326.28$135.92

52281 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.

$275.03

$366.55

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

View every state and territory as a table
52281 office rate range by state
State / territoryOffice rate rangeLocalities
AK$363.221
AL$278.981
AR$275.031
AZ$302.091
CA$326.28–$406.8329
CO$322.101
CT$330.681
DC$353.651
DE$307.021
FL$307.16–$337.243
GA$290.06–$316.322
GU$333.831
HI$333.831
IA$285.301
ID$287.261
IL$298.90–$327.544
IN$288.871
KS$284.291
KY$286.101
LA$285.78–$299.612
MA$320.35–$353.142
MD$312.71–$353.653
ME$289.05–$303.982
MI$293.68–$311.242
MN$307.881
MO$281.17–$300.303
MS$278.141
MT$310.271
NC$291.971
ND$303.151
NE$286.741
NH$317.351
NJ$334.25–$350.152
NM$295.381
NV$308.501
NY$296.29–$365.785
OH$292.231
OK$285.281
OR$305.89–$331.822
PA$292.52–$322.792
PR$312.411
RI$317.591
SC$292.631
SD$302.311
TN$285.731
TX$290.65–$321.218
UT$296.541
VA$303.21–$353.652
VI$312.411
VT$302.271
WA$319.65–$359.962
WI$293.211
WV$288.131
WY$307.171

See 52281 in every payment locality

How the 52281 rate is calculated

Each of 52281’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 · 52281

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.68

2.68 RVUs× 1.000 GPCI

Practice expense6.25

6.25 RVUs× 1.000 GPCI

Malpractice0.36

0.36 RVUs× 1.000 GPCI

Adjusted RVUs

9.2900

Conversion factor

$33.4009

Medicare rate

$310.29

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,124

Code
52281
Physician work
2.68
Practice expense
6.25
Malpractice
0.36

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 52281 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.68× 1.0002.6800
Practice expense6.25× 1.0116.3187
Malpractice0.36× 0.9850.3546
Total RVUs9.3533
Conversion factor× 33.4009

Office rate, Puerto Rico$312.41

Office: (2.68 × 1 + 6.25 × 1.011 + 0.36 × 0.985) × $33.4009 = $312.41

Facility: (2.68 × 1 + 1.05 × 1.011 + 0.36 × 0.985) × $33.4009 = $136.82

Open 52281 in the RVU calculator

Payment rules and modifiers for 52281

The CMS indicators that decide how 52281 is paid alongside other services.

CMS payment indicators · 52281

Urethral dilation, cystoscopic stricture treatment

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

52281 without 51 · national office

$310.29

Urethral dilation, cystoscopic stricture treatment

52281-51 · Second procedure: 50%

$155.15

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 52281

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

Codes related to 52281
CodeHow it relatesOffice range, Puerto Rico
Used instead
52276Urethral stricture treatment, direct-vision incisionTreats a urethral stricture by direct-vision incision rather than calibration or dilation.No office rate
52284Urethral dilation, drug-coated balloonUses a drug-coated balloon technique for cystoscopic treatment of urethral stricture.$2,710.82
53600Urethral dilation, male, initialUrethral stricture dilation by sound or dilator without the cystoscopic service represented by 52281.$91.62
52270Urethrotomy, female urethraReports cystoscopic urethral meatotomy as a distinct service rather than stricture calibration or dilation.$402.63

How 52281 has changed in Puerto Rico

52281 · Office / nonfacility

$312.41

Effective 2026-10-01

The base rate is $14.29 higher than on 2025-10-01, moving from $298.12 to $312.41 (4.8%).

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

    $298.12changed to$312.41

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.75 changed to 2.68
    • Practice expense RVU 6.09 changed to 6.25
    • Malpractice RVU 0.34 changed to 0.36
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $327.24changed to$298.12

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.70 changed to 6.09

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $321.90changed to$327.24

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $333.39changed to$321.90

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $331.76changed to$333.39

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $343.98changed to$331.76

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.81 changed to 6.70
    • Malpractice RVU 0.33 changed to 0.34
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $345.79changed to$343.98

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.79 changed to 6.81
    • Malpractice RVU 0.32 changed to 0.33

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $332.20changed to$345.79

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.09 changed to 6.79
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $308.68changed to$332.20

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.47 changed to 6.09
    • Malpractice RVU 0.31 changed to 0.32
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $284.06changed to$308.68

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.81 changed to 5.47
    • Malpractice RVU 0.30 changed to 0.31

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $250.84changed to$284.06

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.72 changed to 4.81
    • Malpractice RVU 0.31 changed to 0.30
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $219.34changed to$250.84

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.66 changed to 4.72
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $219.63changed to$219.34

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.64 changed to 4.66

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $218.53changed to$219.63

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $213.77changed to$218.53

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.54 changed to 4.64
    • Malpractice RVU 0.28 changed to 0.31
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $209.51changed to$213.77

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.92 changed to 4.54
    • Malpractice RVU 0.29 changed to 0.28
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $209.51

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$312.41$136.82RVU26D
2026-07-01$312.41$136.82RVU26C
2026-04-01$312.41$136.82RVU26B
2026-01-01$312.41$136.82RVU26A
2025-10-01$298.12$146.98RVU25D
2025-07-01$298.12$146.98RVU25C
2025-04-01$298.12$146.98RVU25B
2025-01-01$298.12$146.98RVU25A
2024-10-01$327.24$149.92RVU24D
2024-07-01$327.24$149.92RVU24C
2024-04-01$327.24$149.92RVU24B
2024-03-09$327.24$149.92RVU24AR
2024-01-01$321.90$147.47RVU24A
2023-10-01$333.39$150.98RVU23D
2023-07-01$331.76$150.80RVU23C
2023-04-01$331.76$150.80RVU23B
2023-01-01$331.76$150.80RVU23A
2022-10-01$343.98$152.82RVU22D
2022-07-01$343.98$152.82RVU22C
2022-04-01$343.98$152.82RVU22B
2022-01-01$343.98$152.82RVU22A
2021-10-01$345.79$153.74RVU21D
2021-07-01$345.79$153.74RVU21C
2021-04-01$345.79$153.74RVU21B
2021-01-01$345.79$153.74RVU21A
2020-10-01$332.20$157.95RVU20D
2020-07-01$332.20$157.95RVU20C
2020-04-01$332.20$157.95RVU20B
2020-01-01$332.20$157.95RVU20A
2019-10-01$308.68$158.80RVU19D
2019-07-01$308.68$158.80RVU19C
2019-04-01$308.68$158.80RVU19B
2019-01-01$308.68$158.80RVU19A
2018-10-01$284.06$158.99RVU18D
2018-07-01$284.06$158.99RVU18C
2018-04-01$284.06$158.99RVU18B
2018-01-01$284.06$158.99RVU18AR1
2017-10-01$250.84$147.31RVU17D
2017-07-01$250.84$147.31RVU17C
2017-04-01$250.84$147.31RVU17B
2017-01-01$250.84$147.31RVU17A
2016-10-01$219.34$135.03RVU16D
2016-07-01$219.34$135.03RVU16C
2016-04-01$219.34$135.03RVU16B
2016-01-01$219.34$135.03RVU16A
2015-10-01$219.63$135.52RVU15D
2015-07-01$219.63$135.52RVU15C
2015-04-01$218.53$134.85RVU15B
2015-01-01$218.53$134.85RVU15A
2014-10-01$213.77$133.95RVU14D
2014-07-01$213.77$133.95RVU14C
2014-04-01$213.77$133.95RVU14B
2014-01-01$213.77$133.95RVU14A
2013-10-01$209.51$127.85RVU13D
2013-07-01$209.51$127.85RVU13C
2013-04-01$209.51$127.85RVU13B
2013-01-01$209.51$127.85RVU13AR

Price 52281 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

52281 billing questions

When should 52281 be chosen over direct vision internal urethrotomy?

Use 52281 for cystoscopic calibration or dilation of a urethral narrowing, with or without meatotomy. Direct vision internal urethrotomy uses an incision to treat the stricture and is reported with 52276.

Can meatotomy be included in 52281?

Yes. The service may include meatotomy when performed with the cystoscopic calibration or dilation; document the narrowing and the work performed.

How does CMS price 52281 with another endoscopy?

When related endoscopies are performed together, CMS applies endoscopy-family pricing. The record should support each reported procedure.

Should modifier 50 be appended for a narrowing described on both sides?

No. The descriptor and urethral anatomy do not support bilateral reporting for 52281.

Is an assistant surgeon payable for 52281?

Medicare does not pay an assistant at surgery for this code. Co-surgeon and team-surgery billing 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 52281PPRRVU2026_Oct_nonQPP.csv, line 6,124 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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