Billing code 52284: Urethral dilationMedicare rate & RVUs

Urologists report this cystourethroscopic procedure when treating a urethral stricture with mechanical balloon dilation and therapeutic drug delivery.

CMS RVU26DEffective Oct 1, 2026109 payment localities4K Medicare services in 2024

Medicare pays $2,682.76 for 52284 nationally in the office and $145.96 in a hospital or facility. Local office rates run $2,314.23–$3,823.25.

Medicare rate · 52284

Urethral dilation

Swap in your local Medicare rate.

Work RVUs
3.02
Total RVUs
80.32
Global days
000

National rate · 2026

$2,682.76

Office setting, before claim adjustments.

See every locality for 52284 → · 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 52284 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 52284 covers

A urologist passes a cystoscope to evaluate and access a urethral narrowing, then uses a drug-coated balloon catheter to mechanically widen the stricture and deliver medication to the treated area. The technique is used for urethral stricture disease, including recurrent anterior strictures, and may be performed in a facility or office-based procedure setting. Fluoroscopic guidance is included when performed; it is not required for the code’s description to fit.

Report the code when the documented treatment uses the drug-coated balloon approach, rather than ordinary dilation or incision of the stricture. The operative note should identify the stricture site and treatment performed, including balloon use and drug delivery. The procedure has 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. Bilateral adjustment is inappropriate; assistant-at-surgery services are not paid, and co-surgeon and team-surgery billing 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 52284 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$2314.23 to $3823.25

$2314.23$3068.74$3823.25
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

52284 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$2,356.00$136.30
Alaska*$2,894.32$192.63
Arizona$2,601.25$143.09
Arkansas$2,314.23$135.12
Atlanta$2,726.78$149.40
Austin$2,830.47$146.54
Bakersfield$2,926.19$145.86
Baltimore/Surr. Cntys$2,874.99$153.00
Beaumont$2,450.64$142.15
Brazoria$2,657.58$143.61

52284 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.

$2,314.23

$3,374.15

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
52284 office rate range by state
State / territoryOffice rate rangeLocalities
AK$2,894.321
AL$2,356.001
AR$2,314.231
AZ$2,601.251
CA$2,925.04–$3,823.2529
CO$2,845.531
CT$2,885.321
DC$3,146.941
DE$2,651.121
FL$2,576.28–$2,808.003
GA$2,407.82–$2,726.782
GU$3,029.211
HI$3,029.211
IA$2,456.551
ID$2,470.391
IL$2,466.60–$2,762.884
IN$2,488.541
KS$2,429.691
KY$2,396.511
LA$2,386.79–$2,532.972
MA$2,817.88–$3,183.822
MD$2,713.53–$3,146.943
ME$2,472.33–$2,654.832
MI$2,460.95–$2,601.792
MN$2,748.091
MO$2,327.92–$2,559.483
MS$2,322.291
MT$2,682.731
NC$2,505.941
ND$2,675.021
NE$2,476.861
NH$2,786.461
NJ$2,924.39–$3,101.022
NM$2,472.161
NV$2,683.151
NY$2,550.45–$3,185.895
OH$2,459.371
OK$2,404.991
OR$2,668.62–$2,966.182
PA$2,471.40–$2,792.412
PR$2,710.821
RI$2,768.041
SC$2,485.571
SD$2,674.111
TN$2,442.961
TX$2,450.64–$2,830.478
UT$2,527.301
VA$2,635.26–$3,146.942
VI$2,710.821
VT$2,650.641
WA$2,817.11–$3,268.552
WI$2,565.851
WV$2,351.851
WY$2,679.371

How the 52284 rate is calculated

Each of 52284’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 · 52284

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.02Practice expense 76.91Malpractice 0.39

80.3200 adjusted RVUs×$33.4009 conversion factor=$2,682.76

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

Payment rules and modifiers for 52284

The CMS indicators that decide how 52284 is paid alongside other services.

CMS payment indicators · 52284

Urethral dilation

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

52284 without 51 · national office

$2,682.76

Urethral dilation

52284-51 · Second procedure: 50%

$1,341.38

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

52284 compared with similar codes

Compare codes

52284 vs 52281 vs 52276 vs 53600: national Medicare rates

Swap in your local Medicare rate.

  • 52284
    Urethral dilation · 3.02 wRVU
    $2,682.76
  • 52281
    Urethral dilation · 2.68 wRVU
    $310.29−$2,372.47
  • 52276
    Urethral stricture treatment · 4.87 wRVU
    —
  • 53600
    Urethral dilation · 1.18 wRVU
    $91.18−$2,591.58

How to choose

52281Urethral dilation
Choose 52284 when treatment uses a drug-coated balloon for mechanical dilation and drug delivery. Code 52281 describes urethral stricture dilation by a different method.
52276Urethral stricture treatment
52276 is for endoscopic incision of a urethral stricture. This code is for balloon dilation with therapeutic drug delivery.
53600Urethral dilation
53600 describes urethral dilation by instrumentation without this cystourethroscopic drug-coated balloon treatment.

52284 billing questions

When should this code be chosen instead of 52281?

Use this code for cystourethroscopic treatment with a drug-coated balloon that mechanically dilates the stricture and delivers medication. Code 52281 describes a different dilation approach.

Is cystoscopy separately reported with this procedure?

The cystourethroscopic access and evaluation are part of this procedure. Do not separately report the same cystoscopy as though it were an independent service.

What documentation supports reporting it?

Document the urethral stricture and its site, the drug-coated balloon treatment, and the mechanical dilation and therapeutic drug delivery performed. Include fluoroscopy in the record when used.

Can modifier 50 be used for treatment on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure’s 0-day global period.

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

CMS does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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 52284PPRRVU2026_Oct_nonQPP.csv, line 6,127 (RVU26D)

Open CMS sourceHow we calculate rates

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