CPT code 52301: Ureterocele treatment, cystoscopic incision or resection2026 Medicare rate & RVUs

Medicare pays $255.18 for 52301 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 52301 covers

A ureterocele is a ballooning of the ureter’s lower end where it enters the bladder. In an operating room or endoscopy suite, a urologist passes a cystoscope through the urethra and incises or resects the ureterocele to open the outlet. This is used for ureteroceles associated with impaired drainage, recurrent infection, or other urinary tract problems. The operative report should identify the ureterocele and describe the endoscopic treatment performed.

Report this code when the documented procedure meets its ureterocele-treatment criteria; distinguish it from a less extensive ureterocele incision code by the work recorded, not by diagnosis alone. The minor-procedure global period is zero days, with same-day preoperative and postoperative care included. When related endoscopies are performed together, endoscopy-family pricing applies. The code is priced as bilateral, so modifier 50 does not increase payment. Assistant-at-surgery payment requires documentation of medical necessity; 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 52301 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

52301 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 52301 rate is calculated

Each of 52301’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.

Payment rules and modifiers for 52301

The CMS indicators that decide how 52301 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

52301 compared with similar codes

How to choose

52300Ureterocele treatmentEndoscopic incision or resection

This is the closely related ureterocele-treatment code. Select between the codes based on the specific procedure and extent documented in the operative report.

52305CystourethroscopyCongenital urethral obstruction

This code describes fulguration at specified lower urinary tract sites. It is not the code for incising or resecting a ureterocele.

52310Cystoscopic removalSimple urethral or bladder removal

This code concerns simple removal of a foreign body, calculus, or ureteral stent from the urethra or bladder, rather than ureterocele treatment.

Codes related to 52301

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

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

Open CMS sourceHow we calculate rates