CPT code 52442: Prostatic implant, each implant after the first2026 Medicare rate & RVUs in Missouri
Report this add-on for each additional implant placed during cystoscopic prostatic urethral lift treatment for obstructive symptoms from benign prostatic enlargement.
Medicare pays $750.13–$824.71 for 52442 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
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 52442 covers
During cystoscopy, the urologist places small implants through the urethra to hold obstructing prostate tissue away from the urinary channel. This code represents an implant beyond the first one placed during the same treatment session. Prostatic urethral lift is used to treat urinary symptoms associated with benign prostatic enlargement; the service may be performed in an office or facility setting.
Report this code only with the primary implant-placement procedure, 52441, and count each additional implant separately. The operative note should support the indication, the cystoscopic treatment, and the number of implants placed so the first implant and additional implants can be distinguished. CMS classifies this as an add-on code paid within the primary procedure’s global period. It cannot be reported by itself.
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 52442 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$750.13 to $824.71
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $813.85 | $43.56 |
| Metropolitan St. Louis, MO | $824.71 | $43.76 |
| Rest of Missouri | $750.13 | $43.01 |
How the 52442 rate is calculated
Each of 52442’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 · 52442
RVUs × geographic indexes × conversion factor
Work0.98
0.98 RVUs× 1.000 GPCI
Practice expense24.77
24.77 RVUs× 1.000 GPCI
Malpractice0.13
0.13 RVUs× 1.000 GPCI
Adjusted RVUs
25.8800
Conversion factor
$33.4009
Medicare rate
$864.42
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 52442
The CMS indicators that decide how 52442 is paid alongside other services.
CMS payment indicators · 52442
Prostatic implant, each implant after the first
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
52442 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 52441Prostate implantFirst implant
- 52441 represents the first implant in the session; 52442 represents each additional implant and is reported with 52441.
- 53854Prostate ablationRadiofrequency water vapor
- 53854 describes water vapor thermal treatment of prostate tissue, not placement of implants to retract obstructing tissue.
- 52601TURPElectrosurgical resection
- 52601 is transurethral resection of prostate tissue. Choose it for resection rather than a prostatic urethral lift.
52442 billing questions
When should 52442 be reported instead of 52441?
Use 52441 for the first implant placed during the session. Report 52442 for each implant placed after that first one.
Can 52442 be billed without 52441?
No. It is an add-on code and must be reported with the primary implant-placement code, 52441.
How should the number of additional implants be documented?
The procedure note should state the total number of implants placed and support which implant was the first and which were additional.
Is 52442 paid outside the primary procedure’s global period?
No. CMS identifies it as an add-on code paid within the global period of the primary procedure.
How does this treatment differ from water vapor therapy?
Prostatic urethral lift uses implants to retract obstructing tissue. Water vapor therapy, reported with 53854, treats prostate tissue with thermal energy.
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
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