FeeBase
Log inGet started
Menu

CPT code 52630: Prostate resection, residual or recurrent tissue2026 Medicare rate & RVUs

Reports endoscopic removal of residual or recurrent obstructive prostate tissue, typically when urinary obstruction returns after an earlier prostate resection.

CMS RVU26DEffective Oct 1, 2026109 payment localities5.3K Medicare services in 2024

Medicare pays $376.09 for 52630 nationally in a facility.

Medicare rate · 52630

Prostate resection, residual or recurrent tissue

Office or facility?

Work RVUs
6.39
Total RVUs
11.26
Global days
090

National rate · 2026

$376.09

Facility setting, before claim adjustments.

See every locality for 52630 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 52630 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 52630 covers

A urologist uses a transurethral resectoscope to remove prostate tissue that remains after an earlier resection or has regrown and is again obstructing urine flow. The typical setting is a hospital or ambulatory surgery center, with the patient under anesthesia. The service addresses recurrent or persistent obstruction from prostate tissue, rather than obstruction caused by a bladder-neck contracture. Control of bleeding associated with the operative service is included in this code.

Report 52630 when the operative findings and procedure document removal of residual or recurrent obstructive prostate tissue, not an initial resection of the prostate. The operative note should establish the prior prostate procedure, the obstructive tissue encountered, and the transurethral resection performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. The prostate is not a paired organ for this service, so modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; 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 52630 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

52630 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$347.20
AlaskaUnavailable$479.13
ArizonaUnavailable$367.92
ArkansasUnavailable$343.62
Atlanta, GAUnavailable$384.47
Austin, TXUnavailable$381.19
Bakersfield, CAUnavailable$382.26
Baltimore area, MDUnavailable$395.93
Beaumont, TXUnavailable$361.98
Brazoria, TXUnavailable$370.49

52630 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.

View every state and territory as a table
52630 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 52630 rate is calculated

Each of 52630’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 · 52630

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.39

6.39 RVUs× 1.000 GPCI

Practice expense4.04

4.04 RVUs× 1.000 GPCI

Malpractice0.83

0.83 RVUs× 1.000 GPCI

Adjusted RVUs

11.2600

Conversion factor

$33.4009

Medicare rate

$376.09

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

Payment rules and modifiers for 52630

52630 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 52630

Prostate resection, residual or recurrent tissue

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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.
Split (54/55/56)0.08/0.83/0.09Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 52630

Prostate resection, residual or recurrent tissue

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

52630 without 51 · national facility

$376.09

Prostate resection, residual or recurrent tissue

52630-51 · Second procedure: 50%

$188.05

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

52630 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 52630

    Prostate resection, residual or recurrent tissue6.39 wRVU

    Not priced

  • 52601

    TURP, electrosurgical resection9.75 wRVU

    Not priced

  • 52640

    Bladder neck treatment, contracture resection4.67 wRVU

    Not priced

  • 52648

    Laser prostate surgery, vaporization9.8 wRVU

    Not priced

  • 52649

    Laser enucleation, complete gland enucleation12.68 wRVU

    Not priced

How to choose

52601TURPElectrosurgical resection
Choose 52630 for residual or regrown obstructive tissue after an earlier prostate procedure. Choose 52601 for an initial transurethral prostate resection.
52640Bladder neck treatmentContracture resection
52640 addresses narrowing at the bladder neck. 52630 addresses obstructive prostate tissue that remains or regrows.
52648Laser prostate surgeryVaporization
52648 describes laser vaporization of prostate tissue. 52630 is for transurethral resection of residual or recurrent obstructive tissue.
52649Laser enucleationComplete gland enucleation
52649 describes laser enucleation of prostate tissue. 52630 is for transurethral resection of residual or recurrent obstructive tissue.

Codes related to 52630

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

Codes related to 52630
CodeHow it relatesNational office range
Same family
52601TURP, electrosurgical resectionInitial transurethral prostate resection, rather than resection of residual or recurrent tissue.No office rate
Used instead
52640Bladder neck treatment, contracture resectionTreats bladder-neck contracture, a different source of urinary obstruction.No office rate
52648Laser prostate surgery, vaporizationLaser vaporization is a different operative approach to prostate tissue.No office rate
52649Laser enucleation, complete gland enucleationLaser enucleation is a different operative approach to prostate tissue.No office rate

52630 billing questions

How is 52630 different from 52601?

52630 is for resection of obstructive prostate tissue that remains or regrows after an earlier prostate procedure. Use 52601 for an initial transurethral prostate resection.

Can bleeding control be billed separately?

Control of bleeding associated with the 52630 operative service is included. The code’s descriptor includes this work.

Should modifier 50 be reported?

No. The prostate is not a paired organ for this procedure, so modifier 50 is inappropriate.

What does the 90-day global period include?

It includes the day-before preoperative visit and related postoperative care for 90 days after surgery.

Can an assistant or co-surgeon be billed for 52630?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery 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
RVUs for 52630PPRRVU2026_Oct_nonQPP.csv, line 6,166 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 52630 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 52630 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet