CPT code 53452: Continence balloon, unilateral insertion2026 Medicare rate & RVUs in Georgia
Reports placement of an adjustable continence balloon on one side to treat urinary leakage, commonly in men with stress incontinence after prostate surgery.
CMS doesn’t publish an office rate for 53452 in Georgia.
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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On this page 9 sections
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 in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta, GA | Unavailable | Unavailable |
| Rest of Georgia | Unavailable | Unavailable |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
53452 compared with similar codes
Compare codes · National
5 codes, side by side
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
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