CPT code 52284: Urethral dilation, drug-coated balloon2026 Medicare rate & RVUs in New Mexico
Urologists report this cystourethroscopic procedure when treating a urethral stricture with mechanical balloon dilation and therapeutic drug delivery.
In New Mexico, Medicare pays $2,472.16 for 52284 in the office and $145.92 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 52284 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 52284 covers
A urologist passes a cystoscope to evaluate and access a urethral narrowing, then uses a drug-coated balloon catheter to mechanically widen the stricture and deliver medication to the treated area. The technique is used for urethral stricture disease, including recurrent anterior strictures, and may be performed in a facility or office-based procedure setting. Fluoroscopic guidance is included when performed; it is not required for the code’s description to fit.
Report the code when the documented treatment uses the drug-coated balloon approach, rather than ordinary dilation or incision of the stricture. The operative note should identify the stricture site and treatment performed, including balloon use and drug delivery. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy family pricing applies. Bilateral adjustment is inappropriate; assistant-at-surgery services are not paid, 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 New Mexico compares for 52284
Across 109 of 109 payment localities, the office rate for 52284 runs from $2,314.23 in Arkansas to $3,823.25 in San Benito County, CA. New Mexico pays $2,472.16. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$2,472.16
- Los Angeles, CA · California$3,152.62+$680.46
- Washington, DC area · District of Columbia$3,146.94+$674.78
- Miami, FL · Florida$2,808.00+$335.84
- Chicago, IL · Illinois$2,713.18+$241.02
- Manhattan, NY · New York$3,113.01+$640.85
- Alaska · Alaska$2,894.32+$422.16
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $2,356.00 | $136.30 |
| ArkansasArkansas | $2,314.23 | $135.12 |
| ArizonaArizona | $2,601.25 | $143.09 |
| Bakersfield, CACalifornia | $2,926.19 | $145.86 |
| Chico, CACalifornia | $2,925.04 | $144.71 |
| El Centro, CACalifornia | $2,925.11 | $144.78 |
| Fresno, CACalifornia | $2,925.04 | $144.71 |
| Hanford, CACalifornia | $2,925.04 | $144.71 |
| Madera, CACalifornia | $2,925.04 | $144.71 |
| Merced, CACalifornia | $2,925.04 | $144.71 |
| Modesto, CACalifornia | $2,925.04 | $144.71 |
| Napa, CACalifornia | $3,499.60 | $156.10 |
| Oxnard, CACalifornia | $3,148.21 | $149.71 |
| Redding, CACalifornia | $2,925.04 | $144.71 |
| Rest of CaliforniaCalifornia | $2,925.04 | $144.71 |
| Riverside, CACalifornia | $2,929.27 | $148.94 |
| Sacramento, CACalifornia | $3,099.07 | $148.78 |
| Salinas, CACalifornia | $3,088.29 | $148.14 |
| San Diego, CACalifornia | $3,183.32 | $149.31 |
| Marin County, CACalifornia | $3,738.53 | $161.64 |
| San Francisco, CACalifornia | $3,738.09 | $161.20 |
| San Benito County, CACalifornia | $3,823.25 | $165.19 |
| Santa Clara County, CACalifornia | $3,821.44 | $163.38 |
| San Luis Obispo, CACalifornia | $3,035.50 | $146.09 |
| Santa Cruz, CACalifornia | $3,231.14 | $148.93 |
| Santa Maria, CACalifornia | $3,105.97 | $148.06 |
| Santa Rosa, CACalifornia | $3,265.44 | $150.25 |
| Stockton, CACalifornia | $2,925.04 | $144.71 |
| Vallejo, CACalifornia | $3,498.97 | $155.47 |
| Visalia, CACalifornia | $2,925.04 | $144.71 |
| Yuba City, CACalifornia | $2,925.04 | $144.71 |
| ColoradoColorado | $2,845.53 | $146.37 |
| ConnecticutConnecticut | $2,885.32 | $153.18 |
| DelawareDelaware | $2,651.12 | $144.77 |
| Fort Lauderdale, FLFlorida | $2,726.68 | $156.90 |
| Rest of FloridaFlorida | $2,576.28 | $151.10 |
| Atlanta, GAGeorgia | $2,726.78 | $149.40 |
| Rest of GeorgiaGeorgia | $2,407.82 | $145.00 |
| Hawaii, Guam, HIHawaii | $3,029.21 | $144.87 |
| IowaIowa | $2,456.55 | $135.38 |
| IdahoIdaho | $2,470.39 | $136.53 |
| East St. Louis, ILIllinois | $2,490.46 | $156.61 |
| Rest of IllinoisIllinois | $2,466.60 | $150.51 |
| Suburban Chicago, ILIllinois | $2,762.88 | $157.59 |
| IndianaIndiana | $2,488.54 | $136.93 |
| KansasKansas | $2,429.69 | $136.42 |
| KentuckyKentucky | $2,396.51 | $141.30 |
| New Orleans, LALouisiana | $2,532.97 | $145.84 |
| Rest of LouisianaLouisiana | $2,386.79 | $141.73 |
| Metropolitan Boston, MAMassachusetts | $3,183.82 | $154.89 |
| Rest of MassachusettsMassachusetts | $2,817.88 | $146.63 |
| Baltimore area, MDMaryland | $2,874.99 | $153.00 |
| Rest of MarylandMaryland | $2,713.53 | $146.29 |
| Rest of MaineMaine | $2,472.33 | $138.47 |
| Southern Maine, MEMaine | $2,654.83 | $140.87 |
| Detroit, MIMichigan | $2,601.79 | $153.78 |
| Rest of MichiganMichigan | $2,460.95 | $144.85 |
| MinnesotaMinnesota | $2,748.09 | $137.72 |
| Metropolitan Kansas City, MOMissouri | $2,525.76 | $143.71 |
| Metropolitan St. Louis, MOMissouri | $2,559.48 | $144.45 |
| Rest of MissouriMissouri | $2,327.92 | $141.20 |
| MississippiMississippi | $2,322.29 | $138.11 |
| MontanaMontana | $2,682.73 | $145.94 |
| North CarolinaNorth Carolina | $2,505.94 | $139.11 |
| North DakotaNorth Dakota | $2,675.02 | $138.22 |
| NebraskaNebraska | $2,476.86 | $135.39 |
| New HampshireNew Hampshire | $2,786.46 | $145.65 |
| Northern New JerseyNew Jersey | $3,101.02 | $158.33 |
| Rest of New JerseyNew Jersey | $2,924.39 | $154.21 |
| NevadaNevada | $2,683.15 | $143.82 |
| NYC suburbs and Long Island, NYNew York | $3,185.89 | $169.64 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $2,934.08 | $156.28 |
| Queens, NYNew York | $3,162.51 | $164.01 |
| Rest of New YorkNew York | $2,550.45 | $140.49 |
| OhioOhio | $2,459.37 | $143.28 |
| OklahomaOklahoma | $2,404.99 | $139.63 |
| Portland, OROregon | $2,966.18 | $147.80 |
| Rest of OregonOregon | $2,668.62 | $141.96 |
| Metropolitan Philadelphia, PAPennsylvania | $2,792.41 | $151.61 |
| Rest of PennsylvaniaPennsylvania | $2,471.40 | $142.62 |
| Puerto RicoPuerto Rico | $2,710.82 | $146.12 |
| Rhode IslandRhode Island | $2,768.04 | $147.53 |
| South CarolinaSouth Carolina | $2,485.57 | $141.57 |
| South DakotaSouth Dakota | $2,674.11 | $137.31 |
| TennesseeTennessee | $2,442.96 | $137.01 |
| Austin, TXTexas | $2,830.47 | $146.54 |
| Beaumont, TXTexas | $2,450.64 | $142.15 |
| Brazoria, TXTexas | $2,657.58 | $143.61 |
| Dallas, TXTexas | $2,671.54 | $144.89 |
| Fort Worth, TXTexas | $2,646.02 | $144.74 |
| Galveston, TXTexas | $2,663.34 | $144.30 |
| Houston, TXTexas | $2,670.48 | $151.44 |
| Rest of TexasTexas | $2,550.48 | $143.06 |
| UtahUtah | $2,527.30 | $142.71 |
| VirginiaVirginia | $2,635.26 | $141.59 |
| Virgin Islands, VIUnited States Virgin Islands | $2,710.82 | $146.12 |
| VermontVermont | $2,650.64 | $139.21 |
| Rest of WashingtonWashington | $2,817.11 | $145.86 |
| King County, WAWashington | $3,268.55 | $155.90 |
| WisconsinWisconsin | $2,565.85 | $135.60 |
| West VirginiaWest Virginia | $2,351.85 | $147.38 |
| WyomingWyoming | $2,679.37 | $142.58 |
52284 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.
$2,314.23
$3,374.15
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $2,894.32 | 1 |
| AL | $2,356.00 | 1 |
| AR | $2,314.23 | 1 |
| AZ | $2,601.25 | 1 |
| CA | $2,925.04–$3,823.25 | 29 |
| CO | $2,845.53 | 1 |
| CT | $2,885.32 | 1 |
| DC | $3,146.94 | 1 |
| DE | $2,651.12 | 1 |
| FL | $2,576.28–$2,808.00 | 3 |
| GA | $2,407.82–$2,726.78 | 2 |
| GU | $3,029.21 | 1 |
| HI | $3,029.21 | 1 |
| IA | $2,456.55 | 1 |
| ID | $2,470.39 | 1 |
| IL | $2,466.60–$2,762.88 | 4 |
| IN | $2,488.54 | 1 |
| KS | $2,429.69 | 1 |
| KY | $2,396.51 | 1 |
| LA | $2,386.79–$2,532.97 | 2 |
| MA | $2,817.88–$3,183.82 | 2 |
| MD | $2,713.53–$3,146.94 | 3 |
| ME | $2,472.33–$2,654.83 | 2 |
| MI | $2,460.95–$2,601.79 | 2 |
| MN | $2,748.09 | 1 |
| MO | $2,327.92–$2,559.48 | 3 |
| MS | $2,322.29 | 1 |
| MT | $2,682.73 | 1 |
| NC | $2,505.94 | 1 |
| ND | $2,675.02 | 1 |
| NE | $2,476.86 | 1 |
| NH | $2,786.46 | 1 |
| NJ | $2,924.39–$3,101.02 | 2 |
| NM | $2,472.16 | 1 |
| NV | $2,683.15 | 1 |
| NY | $2,550.45–$3,185.89 | 5 |
| OH | $2,459.37 | 1 |
| OK | $2,404.99 | 1 |
| OR | $2,668.62–$2,966.18 | 2 |
| PA | $2,471.40–$2,792.41 | 2 |
| PR | $2,710.82 | 1 |
| RI | $2,768.04 | 1 |
| SC | $2,485.57 | 1 |
| SD | $2,674.11 | 1 |
| TN | $2,442.96 | 1 |
| TX | $2,450.64–$2,830.47 | 8 |
| UT | $2,527.30 | 1 |
| VA | $2,635.26–$3,146.94 | 2 |
| VI | $2,710.82 | 1 |
| VT | $2,650.64 | 1 |
| WA | $2,817.11–$3,268.55 | 2 |
| WI | $2,565.85 | 1 |
| WV | $2,351.85 | 1 |
| WY | $2,679.37 | 1 |
How the 52284 rate is calculated
Each of 52284’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 · 52284
RVUs × geographic indexes × conversion factor
Work3.02
3.02 RVUs× 1.000 GPCI
Practice expense76.91
76.91 RVUs× 1.000 GPCI
Malpractice0.39
0.39 RVUs× 1.000 GPCI
Adjusted RVUs
80.3200
Conversion factor
$33.4009
Medicare rate
$2,682.76
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,127
- Code
- 52284
- Physician work
- 3.02
- Practice expense
- 76.91
- Malpractice
- 0.39
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.02 | × 1.000 | 3.0200 |
| Practice expense | 76.91 | × 0.917 | 70.5265 |
| Malpractice | 0.39 | × 1.201 | 0.4684 |
| Total RVUs | 74.0149 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Mexico$2472.16
Office: (3.02 × 1 + 76.91 × 0.917 + 0.39 × 1.201) × $33.4009 = $2472.16
Facility: (3.02 × 1 + 0.96 × 0.917 + 0.39 × 1.201) × $33.4009 = $145.92
Payment rules and modifiers for 52284
The CMS indicators that decide how 52284 is paid alongside other services.
CMS payment indicators · 52284
Urethral dilation, drug-coated balloon
| 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
52284 without 51 · national office
$2,682.76
Urethral dilation, drug-coated balloon
52284-51 · Second procedure: 50%
$1,341.38
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%).
How 52284 has changed in New Mexico
52284 · Office / nonfacility
$2472.16
Effective 2026-10-01
The base rate is $219.80 higher than on 2025-10-01, moving from $2252.36 to $2472.16 (9.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$2252.36changed to$2472.16
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 3.10 changed to 3.02
- Practice expense RVU 72.77 changed to 76.91
- Practice expense GPCI 0.908 changed to 0.917
- Malpractice GPCI 1.172 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$2439.00changed to$2252.36
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 76.79 changed to 72.77
- Malpractice RVU 0.38 changed to 0.39
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$2399.19changed to$2439.00
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
No ratechanged to$2399.19
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $2,472.16 | $145.92 | RVU26D |
| 2026-07-01 | $2,472.16 | $145.92 | RVU26C |
| 2026-04-01 | $2,472.16 | $145.92 | RVU26B |
| 2026-01-01 | $2,472.16 | $145.92 | RVU26A |
| 2025-10-01 | $2,252.36 | $156.77 | RVU25D |
| 2025-07-01 | $2,252.36 | $156.77 | RVU25C |
| 2025-04-01 | $2,252.36 | $156.77 | RVU25B |
| 2025-01-01 | $2,252.36 | $156.77 | RVU25A |
| 2024-10-01 | $2,439.00 | $159.73 | RVU24D |
| 2024-07-01 | $2,439.00 | $159.73 | RVU24C |
| 2024-04-01 | $2,439.00 | $159.73 | RVU24B |
| 2024-03-09 | $2,439.00 | $159.73 | RVU24AR |
| 2024-01-01 | $2,399.19 | $157.12 | RVU24A |
| 2023-10-01 | Not in this release | Not in this release | RVU23D |
| 2023-07-01 | Not in this release | Not in this release | RVU23C |
| 2023-04-01 | Not in this release | Not in this release | RVU23B |
| 2023-01-01 | Not in this release | Not in this release | RVU23A |
| 2022-10-01 | Not in this release | Not in this release | RVU22D |
| 2022-07-01 | Not in this release | Not in this release | RVU22C |
| 2022-04-01 | Not in this release | Not in this release | RVU22B |
| 2022-01-01 | Not in this release | Not in this release | RVU22A |
| 2021-10-01 | Not in this release | Not in this release | RVU21D |
| 2021-07-01 | Not in this release | Not in this release | RVU21C |
| 2021-04-01 | Not in this release | Not in this release | RVU21B |
| 2021-01-01 | Not in this release | Not in this release | RVU21A |
| 2020-10-01 | Not in this release | Not in this release | RVU20D |
| 2020-07-01 | Not in this release | Not in this release | RVU20C |
| 2020-04-01 | Not in this release | Not in this release | RVU20B |
| 2020-01-01 | Not in this release | Not in this release | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
52284 billing questions
When should this code be chosen instead of 52281?
Use this code for cystourethroscopic treatment with a drug-coated balloon that mechanically dilates the stricture and delivers medication. Code 52281 describes a different dilation approach.
Is cystoscopy separately reported with this procedure?
The cystourethroscopic access and evaluation are part of this procedure. Do not separately report the same cystoscopy as though it were an independent service.
What documentation supports reporting it?
Document the urethral stricture and its site, the drug-coated balloon treatment, and the mechanical dilation and therapeutic drug delivery performed. Include fluoroscopy in the record when used.
Can modifier 50 be used for treatment on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure’s 0-day global period.
Can an assistant, co-surgeon, or surgical team be reported?
CMS does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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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