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Billing code 52234: Bladder tumor treatmentMedicare rate & RVUs

Report this service for cystoscopic treatment or removal of a bladder tumor measuring 0.5 to 2.0 cm, typically by a urologist.

CMS RVU26DEffective Oct 1, 2026109 payment localities27.4K Medicare services in 2024

Medicare pays $216.77 for 52234 nationally in a facility.

Medicare rate · 52234

Bladder tumor treatment

Swap in your local Medicare rate.

Work RVUs
4.5
Total RVUs
6.49
Global days
000

National rate · 2026

$216.77

Facility setting, before claim adjustments.

See every locality for 52234 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 52234 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 52234 covers

A urologist uses a cystoscope to access the bladder and treat or remove a tumor in the 0.5-to-2.0-cm size range. Treatment may involve resection or destruction of the lesion, including with electrocautery, laser, or cryosurgery. The service is commonly performed in an operating room or outpatient procedural setting for a patient with a bladder tumor identified during evaluation or surveillance.

Choose this level according to the documented tumor size; smaller and larger tumor levels are reported with their corresponding codes. The operative report should describe the lesion size and treatment performed. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and 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 52234 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

52234 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$202.58
Alaska*Unavailable$286.46
ArizonaUnavailable$212.56
ArkansasUnavailable$200.85
AtlantaUnavailable$221.81
AustinUnavailable$217.65
BakersfieldUnavailable$216.74
Baltimore/Surr. CntysUnavailable$227.15
BeaumontUnavailable$211.15
BrazoriaUnavailable$213.36

52234 rates by state

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

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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
52234 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 52234 rate is calculated

Each of 52234’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 · 52234

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.50Practice expense 1.42Malpractice 0.57

6.4900 adjusted RVUs×$33.4009 conversion factor=$216.77

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 52234

The CMS indicators that decide how 52234 is paid alongside other services.

CMS payment indicators · 52234

Bladder tumor treatment

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
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.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

52234 without 51 · national facility

$216.77

Bladder tumor treatment

52234-51 · Second procedure: 50%

$108.39

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

52234 compared with similar codes

Compare codes

52234 vs 52224 vs 52235 vs 52204: national Medicare rates

Swap in your local Medicare rate.

  • 52234
    Bladder tumor treatment · 4.5 wRVU
    —
  • 52224
    Bladder lesion treatment · 3.95 wRVU
    $760.20
  • 52235
    Bladder tumor resection · 5.3 wRVU
    —
  • 52204
    Cystoscopic biopsy · 2.53 wRVU
    $355.39

How to choose

52224Bladder lesion treatment
52224 is the smaller bladder-tumor treatment level; 52234 applies when the documented tumor measures 0.5 to 2.0 cm.
52235Bladder tumor resection
52235 is the next larger bladder-tumor treatment level. Select between the codes using the tumor size documented in the operative report.
52204Cystoscopic biopsy
52204 reports cystoscopic biopsy, while 52234 reports cystoscopic treatment or removal of a bladder tumor in the 0.5-to-2.0-cm range.

Codes related to 52234

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

Codes related to 52234
CodeHow it relatesNational office range
Same family
52224Bladder lesion treatmentCystoscopic treatment of a bladder tumor in a smaller size category.$665.99–$1,037.58
52235Bladder tumor resectionCystoscopic treatment of a bladder tumor in a larger size category.No office rate
52240Bladder tumor treatmentCystoscopic treatment of a bladder tumor in a larger size category.No office rate
Used instead
52204Cystoscopic biopsyUsed for cystoscopic biopsy rather than tumor treatment at this size level.$313.28–$474.12
52214Cystoscopy treatmentCystoscopic fulguration at specified urinary sites, rather than size-based bladder tumor treatment.$636.02–$998.19

52234 billing questions

How is 52234 distinguished from 52224 or 52235?

52234 is for a bladder tumor measuring 0.5 to 2.0 cm. Use the neighboring tumor-treatment level when the documented size falls into that code’s size category.

When would 52204 be considered instead?

52204 describes cystoscopy with biopsy. Code 52234 represents cystoscopic treatment or removal of a bladder tumor in its size range; submitting tissue for pathology during treatment does not by itself establish a separate biopsy service.

Is modifier 50 appropriate for tumors on both sides of the bladder?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

Are same-day preoperative and postoperative visits included?

Yes. The 0-day global period includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be paid for this procedure?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

What happens when related endoscopies are performed during the same session?

CMS endoscopy-family pricing applies when related endoscopies are performed together. Review the other endoscopic services against that family pricing rule.

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 52234PPRRVU2026_Oct_nonQPP.csv, line 6,114 (RVU26D)

Open CMS sourceHow we calculate rates

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