CPT code 53452: Continence balloon, unilateral insertion2026 Medicare rate & RVUs

Reports placement of an adjustable continence balloon on one side to treat urinary leakage, commonly in men with stress incontinence after prostate surgery.

CMS RVU26DEffective Oct 1, 2026109 payment localities37 Medicare services in 2024

Medicare rate · 53452

Continence balloon, unilateral insertion

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
010

National rate · 2026

—

Not priced in the facility setting.

See every locality for 53452 →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 53452 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 53452 covers

This procedure places an adjustable balloon beside the urethra through a perineal approach to help control urinary leakage. Urologists most often use the device for male stress urinary incontinence, including leakage after prostate surgery. The unilateral code applies when the device is placed on one side; the bilateral code is 53451. This code describes implantation, not later device removal or adjustment; those procedures are identified by 53453 and 53454. It also differs from a male sling (53440) or artificial urinary sphincter implantation (53445), which use different continence devices.

For Medicare physician fee schedule purposes, this code has status C: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The procedure has a 10-day global period, which includes related postoperative visits during that period. Modifier 50 is inappropriate for this code. An assistant at surgery is payable only with 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 53452 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

53452 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

53452 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.

View every state and territory as a table
53452 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 53452 rate is calculated

Each of 53452’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 · 53452

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

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

Payment rules and modifiers for 53452

53452 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 53452

Continence balloon, unilateral insertion

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 53452

Continence balloon, unilateral insertion

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

53452 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 53452

    Continence balloon, unilateral insertion0 wRVU

    Not priced

  • 53451

    Balloon device placement, bilateral placement0 wRVU

    Not priced

  • 53453

    Balloon device removal, each balloon0 wRVU

    Not priced

  • 53454

    Balloon device adjustment, transperineal continence device0 wRVU

    Not priced

  • 53440

    Male sling, male stress incontinence13.03 wRVU

    Not priced

How to choose

53451Balloon device placementBilateral placement
53452 is for unilateral balloon placement; 53451 describes bilateral placement. Do not use modifier 50 with 53452.
53453Balloon device removalEach balloon
53453 describes removal of a transperineal continence balloon device, not its initial unilateral placement.
53454Balloon device adjustmentTransperineal continence device
53454 describes adjustment of the balloon device; 53452 is for placing it on one side.
53440Male slingMale stress incontinence
53440 is a male sling procedure. Choose between it and balloon placement based on the operation performed, not simply the incontinence diagnosis.

53452 billing questions

When should I report 53452 rather than 53451?

Use 53452 for unilateral balloon placement and 53451 for bilateral placement. Modifier 50 is not appropriate for 53452.

Does this code describe balloon removal or adjustment?

No. Code 53452 describes unilateral insertion. Code 53453 is for removal, and 53454 is for adjustment.

How does Medicare price 53452?

Its physician fee schedule status is C. CMS publishes no national payment; the Medicare Administrative Contractor sets payment for each claim.

Are related postoperative visits included?

Related postoperative visits during the 10-day global period are included.

Can an assistant, co-surgeon, or surgical team be reported?

An assistant at surgery is payable only when medical necessity is documented. 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

Open CMS sourceHow we calculate rates

Did this answer your question about what 53452 pays?

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

Fee sheets · Coming soon

Put 53452 and the rest of your codes on one sheet

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

Join the waitlist