Billing code 52265: Urethral fulgurationMedicare rate & RVUs

Medicare pays $345.37 for 52265 nationally in the office and $144.29 in a hospital or facility. Local office rates run $305.36–$453.48.

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

What 52265 covers

A urologist passes a cystoscope through the urethra to examine and destroy targeted tissue associated with female urethral syndrome. Fulguration may use cautery, laser, or cryosurgery. The service is distinct from a diagnostic cystoscopy alone and from treatment directed at bladder lesions or other specifically named sites. It is typically performed in an outpatient setting, including an office or a procedure facility.

Report the service when the operative documentation supports the female urethral syndrome indication and identifies the treated tissue and method. The CMS global period is zero days, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies; payment should not be assumed to accrue independently for each procedure. Modifier 50 is inappropriate. Medicare does not pay for an assistant at surgery, and co-surgeons and team surgery are not permitted for this code.

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 52265 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

52265 rates by state

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

How the 52265 rate is calculated

Each of 52265’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.

Payment rules and modifiers for 52265

The CMS indicators that decide how 52265 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

52265 compared with similar codes

How to choose

52214Cystoscopy treatment

Choose 52265 for fulguration associated with female urethral syndrome. Choose 52214 when fulguration targets the specified sites such as the trigone, bladder neck, prostatic fossa, urethra, or periurethral glands.

52224Bladder lesion treatment

52224 is for cystoscopic fulguration of minor bladder lesion(s). 52265 is tied to female urethral syndrome, not the size-based treatment of bladder lesions.

52204Cystoscopic biopsy

52204 reports cystoscopic biopsy. Fulguration associated with female urethral syndrome is the defining service for 52265; use the code that reflects the documented procedure.

52260Bladder distention

52260 describes bladder dilation for interstitial cystitis. It is not the cystoscopic fulguration service for female urethral syndrome reported with 52265.

Codes related to 52265

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

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