CPT code 52285: Urethral meatotomy, female urethral meatus2026 Medicare rate & RVUs in North Carolina

Cystourethroscopy with incision of a narrowed female urethral opening, reported when the surgeon treats meatal narrowing rather than performing dilation alone.

CMS RVU26DEffective Oct 1, 2026One payment locality1.3K Medicare services in 2024

In North Carolina, Medicare pays $307.19 for 52285 in the office and $164.78 when it’s performed in a hospital or facility.

$307.19Office (non-facility)
$164.78Hospital or facility
−5.8%vs the national office rate ($325.99)

Check a contract rate as a % of Medicare · 52285 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 52285 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 52285 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 52285 covers

A urologist uses a cystoscope to inspect the urethra and bladder while surgically opening a narrowed urethral meatus in a female patient. The procedure addresses meatal stenosis that obstructs urine flow or interferes with catheter passage. It may be performed in an operating room or an appropriately equipped outpatient setting; the operative record should identify the narrowing and document the incision or other treatment performed.

Report this code for the female meatal incision service, not for diagnostic cystoscopy alone or for dilation without meatotomy. Documentation should establish the patient’s anatomy, the site and nature of the narrowing, and the treatment performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy-family pricing applies. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, 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 North Carolina compares for 52285

Across 109 of 109 payment localities, the office rate for 52285 runs from $290.93 in Arkansas to $416.33 in San Benito County, CA. North Carolina pays $307.19. The RVUs are the same everywhere; the geographic indexes change the dollars.

52285 in North Carolina vs other payment areas
  1. North Carolina · this page$307.19
  2. Los Angeles, CA · California$360.51+$53.32
  3. Washington, DC area · District of Columbia$368.42+$61.23
  4. Miami, FL · Florida$358.91+$51.72
  5. Chicago, IL · Illinois$348.97+$41.78
  6. Manhattan, NY · New York$374.25+$67.06
  7. Alaska · Alaska$389.77+$82.58

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

52285 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$294.84$161.28
ArkansasArkansas$290.93$159.81
ArizonaArizona$317.67$169.76
Bakersfield, CACalifornia$340.29$172.99
Chico, CACalifornia$338.86$171.57
El Centro, CACalifornia$338.94$171.65
Fresno, CACalifornia$338.86$171.57
Hanford, CACalifornia$338.86$171.57

52285 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.

$290.93

$389.77

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

View every state and territory as a table
52285 office rate range by state
State / territoryOffice rate rangeLocalities
AK$389.771
AL$294.841
AR$290.931
AZ$317.671
CA$338.86–$416.3329
CO$336.131
CT$346.591
DC$368.421
DE$322.621
FL$325.76–$358.913
GA$308.36–$332.712
GU$345.461
HI$345.461
IA$299.771
ID$301.981
IL$318.47–$348.974
IN$303.541
KS$299.411
KY$303.251
LA$303.18–$316.872
MA$334.74–$366.322
MD$328.13–$368.423
ME$304.42–$318.222
MI$311.37–$330.492
MN$320.051
MO$299.02–$316.793
MS$294.981
MT$325.961
NC$307.191
ND$316.271
NE$301.001
NH$331.831
NJ$349.97–$365.272
NM$313.311
NV$323.451
NY$311.51–$383.885
OH$309.391
OK$301.761
OR$320.36–$345.032
PA$309.32–$339.152
PR$327.861
RI$332.801
SC$308.921
SD$315.131
TN$300.911
TX$307.52–$335.528
UT$312.781
VA$317.91–$368.422
VI$327.861
VT$315.981
WA$333.80–$372.532
WI$306.591
WV$307.841
WY$321.741

See 52285 in every payment locality

How the 52285 rate is calculated

Each of 52285’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 · 52285

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.51

3.51 RVUs× 1.000 GPCI

Practice expense5.76

5.76 RVUs× 1.000 GPCI

Malpractice0.49

0.49 RVUs× 1.000 GPCI

Adjusted RVUs

9.7600

Conversion factor

$33.4009

Medicare rate

$325.99

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

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,128

Code
52285
Physician work
3.51
Practice expense
5.76
Malpractice
0.49

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 52285 in North Carolina
ComponentRVULocality factorAdjusted
Physician work3.51× 1.0003.5100
Practice expense5.76× 0.9335.3741
Malpractice0.49× 0.6390.3131
Total RVUs9.1972
Conversion factor× 33.4009

Office rate, North Carolina$307.19

Office: (3.51 × 1 + 5.76 × 0.933 + 0.49 × 0.639) × $33.4009 = $307.19

Facility: (3.51 × 1 + 1.19 × 0.933 + 0.49 × 0.639) × $33.4009 = $164.78

Open 52285 in the RVU calculator

Payment rules and modifiers for 52285

The CMS indicators that decide how 52285 is paid alongside other services.

CMS payment indicators · 52285

Urethral meatotomy, female urethral meatus

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

52285 without 51 · national office

$325.99

Urethral meatotomy, female urethral meatus

52285-51 · Second procedure: 50%

$163.00

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

How 52285 has changed in North Carolina

52285 · Office / nonfacility

$307.19

Effective 2026-10-01

The base rate is $4.46 higher than on 2025-10-01, moving from $302.73 to $307.19 (1.5%).

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

    $302.73changed to$307.19

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.60 changed to 3.51
    • Practice expense RVU 5.86 changed to 5.76
    • Malpractice RVU 0.50 changed to 0.49
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $328.75changed to$302.73

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.44 changed to 5.86
    • Malpractice RVU 0.47 changed to 0.50

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $323.38changed to$328.75

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $335.99changed to$323.38

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.46 changed to 6.44
    • Malpractice RVU 0.44 changed to 0.47
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $346.16changed to$335.99

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.52 changed to 6.46
    • Malpractice RVU 0.43 changed to 0.44
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $337.01changed to$346.16

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.14 changed to 6.52
    • Malpractice RVU 0.44 changed to 0.43

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $317.48changed to$337.01

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.23 changed to 6.14
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $296.03changed to$317.48

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.65 changed to 5.23
    • Malpractice RVU 0.41 changed to 0.44
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $275.34changed to$296.03

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.05 changed to 4.65
    • Malpractice RVU 0.40 changed to 0.41

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $273.29changed to$275.34

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.99 changed to 4.05
    • Malpractice RVU 0.41 changed to 0.40
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $271.03changed to$273.29

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.93 changed to 3.99
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $271.34changed to$271.03

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.91 changed to 3.93

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $269.99changed to$271.34

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $265.93changed to$269.99

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.84 changed to 3.91
    • Malpractice RVU 0.35 changed to 0.41
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $262.12changed to$265.93

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.15 changed to 3.84
    • Malpractice RVU 0.37 changed to 0.35
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $262.12

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$307.19$164.78RVU26D
2026-07-01$307.19$164.78RVU26C
2026-04-01$307.19$164.78RVU26B
2026-01-01$307.19$164.78RVU26A
2025-10-01$302.73$180.22RVU25D
2025-07-01$302.73$180.22RVU25C
2025-04-01$302.73$180.22RVU25B
2025-01-01$302.73$180.22RVU25A
2024-10-01$328.75$183.56RVU24D
2024-07-01$328.75$183.56RVU24C
2024-04-01$328.75$183.56RVU24B
2024-03-09$328.75$183.56RVU24AR
2024-01-01$323.38$180.57RVU24A
2023-10-01$335.99$185.83RVU23D
2023-07-01$335.99$185.83RVU23C
2023-04-01$335.99$185.83RVU23B
2023-01-01$335.99$185.83RVU23A
2022-10-01$346.16$189.12RVU22D
2022-07-01$346.16$189.12RVU22C
2022-04-01$346.16$189.12RVU22B
2022-01-01$346.16$189.12RVU22A
2021-10-01$337.01$191.29RVU21D
2021-07-01$337.01$191.29RVU21C
2021-04-01$337.01$191.29RVU21B
2021-01-01$337.01$191.29RVU21A
2020-10-01$317.48$195.64RVU20D
2020-07-01$317.48$195.64RVU20C
2020-04-01$317.48$195.64RVU20B
2020-01-01$317.48$195.64RVU20A
2019-10-01$296.03$195.37RVU19D
2019-07-01$296.03$195.37RVU19C
2019-04-01$296.03$195.37RVU19B
2019-01-01$296.03$195.37RVU19A
2018-10-01$275.34$195.91RVU18D
2018-07-01$275.34$195.91RVU18C
2018-04-01$275.34$195.91RVU18B
2018-01-01$275.34$195.91RVU18AR1
2017-10-01$273.29$195.43RVU17D
2017-07-01$273.29$195.43RVU17C
2017-04-01$273.29$195.43RVU17B
2017-01-01$273.29$195.43RVU17A
2016-10-01$271.03$194.45RVU16D
2016-07-01$271.03$194.45RVU16C
2016-04-01$271.03$194.45RVU16B
2016-01-01$271.03$194.45RVU16A
2015-10-01$271.34$195.15RVU15D
2015-07-01$271.34$195.15RVU15C
2015-04-01$269.99$194.18RVU15B
2015-01-01$269.99$194.18RVU15A
2014-10-01$265.93$192.39RVU14D
2014-07-01$265.93$192.39RVU14C
2014-04-01$265.93$192.39RVU14B
2014-01-01$265.93$192.39RVU14A
2013-10-01$262.12$185.48RVU13D
2013-07-01$262.12$185.48RVU13C
2013-04-01$262.12$185.48RVU13B
2013-01-01$262.12$185.48RVU13AR

Price 52285 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

52285 billing questions

How does this differ from 52270?

52285 is the female urethral meatotomy service; 52270 is its male counterpart. Select based on the patient’s anatomy and the procedure documented.

Can this be reported for urethral dilation alone?

No. This code describes meatotomy with cystourethroscopy; dilation without the meatotomy is a different service.

Can diagnostic cystoscopy be billed separately?

The cystourethroscopic inspection is part of this operative service. Do not separately report a diagnostic cystoscopy for the same operative examination.

What documentation supports reporting this code?

Document female anatomy, the narrowed meatus, the clinical reason for treatment, and the incision or other meatotomy performed.

Which surgical modifiers are appropriate for multiple surgeons?

CMS does not permit assistant-at-surgery, co-surgeon, or team-surgery payment for this code. Modifier 50 is also inappropriate.

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 52285PPRRVU2026_Oct_nonQPP.csv, line 6,128 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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