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Billing code 52402: Ejaculatory duct procedureMedicare rate & RVUs

A urologist uses a cystoscope to incise or resect ejaculatory ducts, typically to treat obstruction associated with male infertility.

CMS RVU26DEffective Oct 1, 2026109 payment localities14 Medicare services in 2024

Medicare pays $230.80 for 52402 nationally in a facility.

Medicare rate · 52402

Ejaculatory duct procedure

Swap in your local Medicare rate.

Work RVUs
5.14
Total RVUs
6.91
Global days
000

National rate · 2026

$230.80

Facility setting, before claim adjustments.

See every locality for 52402 → · 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 9 sections
  1. Medicare rate
  2. What 52402 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Billing questions
  9. Sources

What 52402 covers

A urologist performs this endoscopic procedure by passing instruments through the urethra to reach and open or resect the ejaculatory ducts. It is generally used when obstruction of these ducts is linked to impaired semen flow or male infertility. The service is typically performed in a facility setting, such as a hospital or ambulatory surgery center, with the patient under anesthesia.

Report 52402 when the documented work targets the ejaculatory ducts, rather than the prostate or congenital posterior urethral valves. The operative note should identify the indication, endoscopic findings, and the incision or resection 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 code. Medicare does not pay an assistant at surgery, 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 52402 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

52402 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$216.70
Alaska*Unavailable$309.32
ArizonaUnavailable$226.51
ArkansasUnavailable$215.00
AtlantaUnavailable$236.28
AustinUnavailable$230.84
BakersfieldUnavailable$229.16
Baltimore/Surr. CntysUnavailable$241.42
BeaumontUnavailable$225.89
BrazoriaUnavailable$227.06

52402 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
52402 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 52402 rate is calculated

Each of 52402’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 · 52402

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.14Practice expense 1.12Malpractice 0.65

6.9100 adjusted RVUs×$33.4009 conversion factor=$230.80

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

Payment rules and modifiers for 52402

The CMS indicators that decide how 52402 is paid alongside other services.

CMS payment indicators · 52402

Ejaculatory duct procedure

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

52402 without 51 · national facility

$230.80

Ejaculatory duct procedure

52402-51 · Second procedure: 50%

$115.40

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

52402 compared with similar codes

Compare codes

52402 vs 52400 vs 52000 vs 52450 vs 52601: national Medicare rates

Swap in your local Medicare rate.

  • 52402
    Ejaculatory duct procedure · 5.14 wRVU
    —
  • 52400
    Valve incision · 8.47 wRVU
    —
  • 52000
    Cystoscopy · 1.49 wRVU
    $215.77
  • 52450
    Prostate incision · 7.59 wRVU
    —
  • 52601
    TURP · 9.75 wRVU
    —

How to choose

52400Valve incision
52400 treats congenital posterior urethral valves. Choose 52402 when the endoscopic target is the ejaculatory ducts.
52000Cystoscopy
52000 is diagnostic cystourethroscopy. In 52402, cystourethroscopy is used to perform a therapeutic incision or resection of the ejaculatory ducts.
52450Prostate incision
52450 is a transurethral incision of the prostate. It is not the code for incision or resection of the ejaculatory ducts.
52601TURP
52601 describes transurethral resection of prostate tissue. Use 52402 when the operative target is the ejaculatory ducts, not the prostate.

52402 billing questions

How is 52402 different from 52400?

52402 treats the ejaculatory ducts. Code 52400 is for endoscopic treatment of congenital posterior urethral valves.

Can diagnostic cystoscopy be reported separately?

Cystourethroscopy is part of the described procedure. The diagnostic look used to perform the duct incision or resection is not a separate service.

Should modifier 50 be appended for bilateral duct work?

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

What global period applies?

The global period is 0 days. Same-day preoperative and postoperative care is included.

Can an assistant surgeon or co-surgeon be paid?

Medicare does not pay an assistant at surgery for 52402. Co-surgeons and team surgery are also not permitted.

What if another related endoscopy is performed in the same session?

CMS endoscopy family pricing applies when related endoscopies are performed together. Document the procedures performed and their distinct targets.

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 52402PPRRVU2026_Oct_nonQPP.csv, line 6,157 (RVU26D)

Open CMS sourceHow we calculate rates

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