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Billing code 52260: Bladder distentionMedicare rate & RVUs

Reports cystoscopic bladder distention for interstitial cystitis when performed under general or spinal anesthesia.

CMS RVU26DEffective Oct 1, 2026109 payment localities4.6K Medicare services in 2024

Medicare pays $185.71 for 52260 nationally in a facility.

Medicare rate · 52260

Bladder distention

Swap in your local Medicare rate.

Work RVUs
3.81
Total RVUs
5.56
Global days
000

National rate · 2026

$185.71

Facility setting, before claim adjustments.

See every locality for 52260 → · 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 52260 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 52260 covers

A urologist passes a cystoscope into the bladder and distends the bladder with fluid as treatment for interstitial cystitis. This code is for the procedure performed under general or spinal anesthesia, commonly in an operating room or outpatient surgical setting. The anesthesia type distinguishes it from the corresponding local-anesthesia service.

The operative note should support the interstitial cystitis indication, cystoscopic bladder distention, and anesthesia used. The procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate for this bladder procedure. 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 52260 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

52260 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$173.14
Alaska*Unavailable$244.38
ArizonaUnavailable$181.97
ArkansasUnavailable$171.61
AtlantaUnavailable$190.18
AustinUnavailable$186.42
BakersfieldUnavailable$185.44
Baltimore/Surr. CntysUnavailable$194.81
BeaumontUnavailable$180.77
BrazoriaUnavailable$182.61

52260 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
52260 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 52260 rate is calculated

Each of 52260’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 · 52260

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.81Practice expense 1.24Malpractice 0.51

5.5600 adjusted RVUs×$33.4009 conversion factor=$185.71

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

Payment rules and modifiers for 52260

The CMS indicators that decide how 52260 is paid alongside other services.

CMS payment indicators · 52260

Bladder distention

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

52260 without 51 · national facility

$185.71

Bladder distention

52260-51 · Second procedure: 50%

$92.86

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

52260 compared with similar codes

Compare codes

52260 vs 52265 vs 52204 vs 52224: national Medicare rates

Swap in your local Medicare rate.

  • 52260
    Bladder distention · 3.81 wRVU
    —
  • 52265
    Urethral fulguration · 2.87 wRVU
    $345.37
  • 52204
    Cystoscopic biopsy · 2.53 wRVU
    $355.39
  • 52224
    Bladder lesion treatment · 3.95 wRVU
    $760.20

How to choose

52265Urethral fulguration
Both codes cover cystoscopic bladder distention for interstitial cystitis. Choose 52260 for general or spinal anesthesia and 52265 for local anesthesia.
52204Cystoscopic biopsy
52204 reports bladder biopsy obtained during cystoscopy. Use 52260 for bladder distention to treat interstitial cystitis, not for tissue sampling alone.
52224Bladder lesion treatment
52224 is used for cystoscopic treatment of small bladder lesions. 52260 describes bladder distention for interstitial cystitis rather than lesion treatment.

Codes related to 52260

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

Codes related to 52260
CodeHow it relatesNational office range
Used instead
52265Urethral fulgurationCorresponding bladder-distention procedure when local anesthesia is used.$305.36–$453.48
Often billed with
52204Cystoscopic biopsyA distinct bladder biopsy may be performed during the same cystoscopic encounter.$313.28–$474.12
52224Bladder lesion treatmentMay accompany the encounter for separate treatment of a small bladder lesion.$665.99–$1,037.58

52260 billing questions

How is 52260 distinguished from 52265?

Both describe cystoscopic bladder distention for interstitial cystitis. Report 52260 when performed under general or spinal anesthesia; 52265 is the local-anesthesia counterpart.

What documentation supports 52260?

Document interstitial cystitis as the indication, the cystoscopic bladder distention performed, and the use of general or spinal anesthesia.

Can modifier 50 be appended?

No. The bladder procedure is not bilateral, and modifier 50 is inappropriate.

How are related endoscopies handled when performed together?

CMS endoscopy family pricing applies when related endoscopies are performed together. The same-day preoperative and postoperative care is included in the 0-day global period.

Can an assistant or co-surgeon be paid for 52260?

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 52260PPRRVU2026_Oct_nonQPP.csv, line 6,118 (RVU26D)

Open CMS sourceHow we calculate rates

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