Billing code 52285: Urethral meatotomyMedicare rate & RVUs
Cystourethroscopy with incision of a narrowed female urethral opening, reported when the surgeon treats meatal narrowing rather than performing dilation alone.
Medicare pays $325.99 for 52285 nationally in the office and $173.35 in a hospital or facility. Local office rates run $290.93–$416.33.
Medicare rate · 52285
Urethral meatotomy
Swap in your local Medicare rate.
- Work RVUs
- 3.51
- Total RVUs
- 9.76
- Global days
- 000
National rate · 2026
$325.99
Office setting, before claim adjustments.
See every locality for 52285 → · 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
What 52285 covers
A urologist uses a cystoscope to inspect the urethra and bladder while surgically opening a narrowed urethral meatus in a female patient. The procedure addresses meatal stenosis that obstructs urine flow or interferes with catheter passage. It may be performed in an operating room or an appropriately equipped outpatient setting; the operative record should identify the narrowing and document the incision or other treatment performed.
Report this code for the female meatal incision service, not for diagnostic cystoscopy alone or for dilation without meatotomy. Documentation should establish the patient’s anatomy, the site and nature of the narrowing, and the treatment performed. CMS assigns 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 service. Medicare does not pay an assistant at surgery, 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 52285 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
$290.93 to $416.33
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $294.84 | $161.28 |
| Alaska* | $389.77 | $227.20 |
| Arizona | $317.67 | $169.76 |
| Arkansas | $290.93 | $159.81 |
| Atlanta | $332.71 | $177.63 |
| Austin | $335.52 | $174.02 |
| Bakersfield | $340.29 | $172.99 |
| Baltimore/Surr. Cntys | $345.79 | $182.01 |
| Beaumont | $307.52 | $168.61 |
| Brazoria | $321.60 | $170.33 |
| Chicago | $348.97 | $195.56 |
| Chico | $338.86 | $171.57 |
| Colorado | $336.13 | $173.72 |
| Connecticut | $346.59 | $182.19 |
| Dallas | $323.95 | $171.92 |
| Dc + Md/Va Suburbs | $368.42 | $188.61 |
| Delaware | $322.62 | $171.81 |
| Detroit | $330.49 | $183.19 |
| East St. Louis | $327.20 | $186.77 |
| El Centro | $338.94 | $171.65 |
| Fort Lauderdale | $341.72 | $187.09 |
| Fort Worth | $322.24 | $171.74 |
| Fresno | $338.86 | $171.57 |
| Galveston | $322.77 | $171.20 |
| Hanford-Corcoran | $338.86 | $171.57 |
| Hawaii, Guam | $345.46 | $171.91 |
| Houston | $331.74 | $180.16 |
| Idaho | $301.98 | $161.55 |
| Indiana | $303.54 | $162.04 |
| Iowa | $299.77 | $160.10 |
| Kansas | $299.41 | $161.42 |
| Kentucky | $303.25 | $167.55 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $360.51 | $179.93 |
| Madera | $338.86 | $171.57 |
| Manhattan | $374.25 | $196.88 |
| Merced | $338.86 | $171.57 |
| Metropolitan Boston | $366.32 | $184.07 |
| Metropolitan Kansas City | $313.88 | $170.55 |
| Metropolitan Philadelphia | $339.15 | $180.25 |
| Metropolitan St. Louis | $316.79 | $171.48 |
| Miami | $358.91 | $200.00 |
| Minnesota | $320.05 | $162.98 |
| Mississippi | $294.98 | $163.55 |
| Modesto | $338.86 | $171.57 |
| Montana** | $325.96 | $173.32 |
| Napa | $386.51 | $185.32 |
| Nebraska | $301.00 | $160.11 |
| Nevada** | $323.45 | $170.66 |
| New Hampshire | $331.83 | $172.93 |
| New Mexico | $313.31 | $173.34 |
| New Orleans | $316.87 | $173.23 |
| North Carolina | $307.19 | $164.78 |
| North Dakota** | $316.27 | $163.63 |
| Northern Nj | $365.27 | $188.21 |
| Nyc Suburbs/Long Island | $383.88 | $202.39 |
| Ohio | $309.39 | $170.02 |
| Oklahoma | $301.76 | $165.45 |
| Oxnard-Thousand Oaks-Ventura | $358.12 | $177.70 |
| Portland | $345.03 | $175.45 |
| Poughkpsie/N Nyc Suburbs | $352.98 | $185.84 |
| Puerto Rico | $327.86 | $173.54 |
| Queens | $375.74 | $195.32 |
| Redding | $338.86 | $171.57 |
| Rest Of California | $338.86 | $171.57 |
| Rest Of Florida | $325.76 | $179.83 |
| Rest Of Georgia | $308.36 | $172.20 |
| Rest Of Illinois | $318.47 | $179.11 |
| Rest Of Louisiana | $303.18 | $168.09 |
| Rest Of Maine | $304.42 | $163.98 |
| Rest Of Maryland | $328.13 | $173.66 |
| Rest Of Massachusetts | $334.74 | $174.01 |
| Rest Of Michigan | $311.37 | $172.00 |
| Rest Of Missouri | $299.02 | $167.44 |
| Rest Of New Jersey | $349.97 | $183.28 |
| Rest Of New York | $311.51 | $166.50 |
| Rest Of Oregon | $320.36 | $168.33 |
| Rest Of Pennsylvania | $309.32 | $169.19 |
| Rest Of Texas | $314.59 | $169.74 |
| Rest Of Washington | $333.80 | $173.07 |
| Rhode Island | $332.80 | $175.12 |
| Riverside-San Bernardino-Ontario | $344.17 | $176.87 |
| Sacramento-Roseville-Folsom | $353.98 | $176.46 |
| Salinas | $352.62 | $175.71 |
| San Diego-Chula Vista-Carlsbad | $359.72 | $177.16 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $407.16 | $191.93 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $406.60 | $191.37 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $416.33 | $196.22 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $414.06 | $193.95 |
| San Luis Obispo-Paso Robles | $347.13 | $173.27 |
| Santa Cruz-Watsonville | $362.22 | $176.76 |
| Santa Maria-Santa Barbara | $353.62 | $175.64 |
| Santa Rosa-Petaluma | $365.78 | $178.34 |
| Seattle (King Cnty) | $372.53 | $185.24 |
| South Carolina | $308.92 | $167.87 |
| South Dakota** | $315.13 | $162.48 |
| Southern Maine | $318.22 | $166.95 |
| Stockton | $338.86 | $171.57 |
| Suburban Chicago | $344.64 | $187.88 |
| Tennessee | $300.91 | $162.16 |
| Utah | $312.78 | $169.30 |
| Vallejo | $385.70 | $184.52 |
| Vermont | $315.98 | $164.87 |
| Virgin Islands | $327.86 | $173.54 |
| Virginia | $317.91 | $167.86 |
| Visalia | $338.86 | $171.57 |
| West Virginia | $307.84 | $175.20 |
| Wisconsin | $306.59 | $160.36 |
| Wyoming** | $321.74 | $169.10 |
| Yuba City | $338.86 | $171.57 |
52285 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.
$290.93
$389.77
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $389.77 | 1 |
| AL | $294.84 | 1 |
| AR | $290.93 | 1 |
| AZ | $317.67 | 1 |
| CA | $338.86–$416.33 | 29 |
| CO | $336.13 | 1 |
| CT | $346.59 | 1 |
| DC | $368.42 | 1 |
| DE | $322.62 | 1 |
| FL | $325.76–$358.91 | 3 |
| GA | $308.36–$332.71 | 2 |
| GU | $345.46 | 1 |
| HI | $345.46 | 1 |
| IA | $299.77 | 1 |
| ID | $301.98 | 1 |
| IL | $318.47–$348.97 | 4 |
| IN | $303.54 | 1 |
| KS | $299.41 | 1 |
| KY | $303.25 | 1 |
| LA | $303.18–$316.87 | 2 |
| MA | $334.74–$366.32 | 2 |
| MD | $328.13–$368.42 | 3 |
| ME | $304.42–$318.22 | 2 |
| MI | $311.37–$330.49 | 2 |
| MN | $320.05 | 1 |
| MO | $299.02–$316.79 | 3 |
| MS | $294.98 | 1 |
| MT | $325.96 | 1 |
| NC | $307.19 | 1 |
| ND | $316.27 | 1 |
| NE | $301.00 | 1 |
| NH | $331.83 | 1 |
| NJ | $349.97–$365.27 | 2 |
| NM | $313.31 | 1 |
| NV | $323.45 | 1 |
| NY | $311.51–$383.88 | 5 |
| OH | $309.39 | 1 |
| OK | $301.76 | 1 |
| OR | $320.36–$345.03 | 2 |
| PA | $309.32–$339.15 | 2 |
| PR | $327.86 | 1 |
| RI | $332.80 | 1 |
| SC | $308.92 | 1 |
| SD | $315.13 | 1 |
| TN | $300.91 | 1 |
| TX | $307.52–$335.52 | 8 |
| UT | $312.78 | 1 |
| VA | $317.91–$368.42 | 2 |
| VI | $327.86 | 1 |
| VT | $315.98 | 1 |
| WA | $333.80–$372.53 | 2 |
| WI | $306.59 | 1 |
| WV | $307.84 | 1 |
| WY | $321.74 | 1 |
How the 52285 rate is calculated
Each of 52285’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 · 52285
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.51Practice expense 5.76Malpractice 0.49
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 52285
The CMS indicators that decide how 52285 is paid alongside other services.
CMS payment indicators · 52285
Urethral meatotomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
52285 without 51 · national office
$325.99
Urethral meatotomy
52285-51 · Second procedure: 50%
$163.00
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%).
52285 compared with similar codes
Compare codes
52285 vs 52270 vs 52275 vs 52281: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 52270Urethrotomy
- This code is for female urethral meatotomy; 52270 is the male counterpart.
- 52275Urethrotomy
- 52275 describes internal urethrotomy, a different incision procedure. Use 52285 when the documented treatment is female urethral meatotomy.
- 52281Urethral dilation
- 52281 covers urethral calibration or dilation. It is not the code for an incision of the female urethral meatus.
52285 billing questions
How does this differ from 52270?
52285 is the female urethral meatotomy service; 52270 is its male counterpart. Select based on the patient’s anatomy and the procedure documented.
Can this be reported for urethral dilation alone?
No. This code describes meatotomy with cystourethroscopy; dilation without the meatotomy is a different service.
Can diagnostic cystoscopy be billed separately?
The cystourethroscopic inspection is part of this operative service. Do not separately report a diagnostic cystoscopy for the same operative examination.
What documentation supports reporting this code?
Document female anatomy, the narrowed meatus, the clinical reason for treatment, and the incision or other meatotomy performed.
Which surgical modifiers are appropriate for multiple surgeons?
CMS does not permit assistant-at-surgery, co-surgeon, or team-surgery payment for this code. Modifier 50 is also inappropriate.
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
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