CPT code 52443: Prostate incision2026 Medicare rate & RVUs
Cystourethroscopic transurethral incision of the prostatic commissure to relieve urinary outlet obstruction is reported for the specific prostate incision performed.
Medicare pays $5,904.28 for 52443 nationally in the office and $172.35 in a hospital or facility. Local office rates run $5,083.54–$8,459.90.
Medicare rate · 52443
Prostate incision
- Work RVUs
- 3.62
- Total RVUs
- 176.77
- Global days
- 000
National rate · 2026
$5,904.28
Office setting, before claim adjustments.
See every locality for 52443 →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.
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On this page 10 sections
What 52443 covers
A urologist performs this endoscopic procedure through the urethra, using a cystourethroscope to incise the prostatic commissure and open the narrowed urinary passage. It is used for selected patients with prostatic obstruction causing lower urinary tract symptoms. The operative report should identify the prostatic incision performed and the endoscopic approach; it should not describe a different prostate procedure such as implant placement or tissue resection in its place.
Report the code for the documented commissurotomy rather than selecting a code solely from the diagnosis of benign prostatic enlargement. The service 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 code. 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 52443 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
$5083.54 to $8459.90
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $5,176.61 | $161.17 |
| Alaska | $6,332.75 | $228.25 |
| Arizona | $5,723.26 | $169.02 |
| Arkansas | $5,083.54 | $159.81 |
| Atlanta, GA | $6,000.02 | $176.38 |
| Austin, TX | $6,237.31 | $172.93 |
| Bakersfield, CA | $6,454.30 | $172.10 |
| Baltimore area, MD | $6,330.92 | $180.56 |
| Beaumont, TX | $5,384.07 | $168.01 |
| Brazoria, TX | $5,849.95 | $169.61 |
| Chicago, IL | $5,953.86 | $193.27 |
| Chico, CA | $6,452.93 | $170.74 |
| Colorado | $6,271.52 | $172.74 |
| Connecticut | $6,354.06 | $180.77 |
| Dallas, TX | $5,880.11 | $171.11 |
| Delaware | $5,834.11 | $170.97 |
| Detroit, MI | $5,712.94 | $181.63 |
| East St. Louis, IL | $5,458.42 | $185.04 |
| El Centro, CA | $6,453.01 | $170.81 |
| Fort Lauderdale, FL | $5,991.68 | $185.23 |
| Fort Worth, TX | $5,822.63 | $170.95 |
| Fresno, CA | $6,452.93 | $170.74 |
| Galveston, TX | $5,862.23 | $170.42 |
| Hanford, CA | $6,452.93 | $170.74 |
| Hawaii, Guam, HI | $6,688.02 | $170.82 |
| Houston, TX | $5,870.65 | $178.84 |
| Idaho | $5,434.74 | $161.37 |
| Indiana | $5,475.32 | $161.82 |
| Iowa | $5,404.73 | $160.02 |
| Kansas | $5,342.93 | $161.26 |
| Kentucky | $5,262.72 | $167.04 |
| King County, WA | $7,216.85 | $183.77 |
| Los Angeles, CA | $6,959.62 | $178.74 |
| Madera, CA | $6,452.93 | $170.74 |
| Manhattan, NY | $6,855.44 | $194.93 |
| Marin County, CA | $8,272.33 | $190.31 |
| Merced, CA | $6,452.93 | $170.74 |
| Metropolitan Boston, MA | $7,026.54 | $182.61 |
| Metropolitan Kansas City, MO | $5,552.08 | $169.79 |
| Metropolitan Philadelphia, PA | $6,145.91 | $178.97 |
| Metropolitan St. Louis, MO | $5,627.44 | $170.65 |
| Miami, FL | $6,164.26 | $197.32 |
| Minnesota | $6,060.73 | $162.58 |
| Mississippi | $5,098.51 | $163.32 |
| Modesto, CA | $6,452.93 | $170.74 |
| Montana | $5,904.25 | $172.32 |
| Napa, CA | $7,738.56 | $183.88 |
| Nebraska | $5,450.58 | $160.01 |
| Nevada | $5,907.48 | $169.82 |
| New Hampshire | $6,138.84 | $171.91 |
| New Mexico | $5,428.62 | $172.44 |
| New Orleans, LA | $5,566.05 | $172.31 |
| North Carolina | $5,512.27 | $164.39 |
| North Dakota | $5,895.15 | $163.22 |
| Northern New Jersey | $6,835.82 | $186.78 |
| NYC suburbs and Long Island, NY | $7,015.33 | $200.07 |
| Ohio | $5,402.58 | $169.33 |
| Oklahoma | $5,283.67 | $165.06 |
| Oxnard, CA | $6,951.65 | $176.51 |
| Portland, OR | $6,542.53 | $174.35 |
| Poughkeepsie and northern NYC suburbs, NY | $6,460.90 | $184.44 |
| Puerto Rico | $5,967.49 | $172.51 |
| Queens, NY | $6,968.58 | $193.44 |
| Redding, CA | $6,452.93 | $170.74 |
| Rest of California | $6,452.93 | $170.74 |
| Rest of Florida | $5,658.21 | $178.49 |
| Rest of Georgia | $5,284.28 | $171.40 |
| Rest of Illinois | $5,411.11 | $177.86 |
| Rest of Louisiana | $5,240.31 | $167.55 |
| Rest of Maine | $5,437.03 | $163.66 |
| Rest of Maryland | $5,973.44 | $172.73 |
| Rest of Massachusetts | $6,208.80 | $173.08 |
| Rest of Michigan | $5,404.44 | $171.19 |
| Rest of Missouri | $5,107.89 | $166.97 |
| Rest of New Jersey | $6,441.26 | $181.99 |
| Rest of New York | $5,611.31 | $165.98 |
| Rest of Oregon | $5,876.64 | $167.64 |
| Rest of Pennsylvania | $5,430.46 | $168.55 |
| Rest of Texas | $5,608.62 | $169.02 |
| Rest of Washington | $6,207.88 | $172.16 |
| Rhode Island | $6,095.26 | $174.18 |
| Riverside, CA | $6,457.92 | $175.73 |
| Sacramento, CA | $6,841.69 | $175.45 |
| Salinas, CA | $6,818.01 | $174.70 |
| San Benito County, CA | $8,459.90 | $194.46 |
| San Diego, CA | $7,031.40 | $176.01 |
| San Francisco, CA | $8,271.81 | $189.79 |
| San Luis Obispo, CA | $6,700.96 | $172.29 |
| Santa Clara County, CA | $8,457.77 | $192.33 |
| Santa Cruz, CA | $7,139.81 | $175.51 |
| Santa Maria, CA | $6,858.02 | $174.59 |
| Santa Rosa, CA | $7,215.88 | $177.07 |
| South Carolina | $5,463.60 | $167.30 |
| South Dakota | $5,894.08 | $162.15 |
| Southern Maine, ME | $5,846.70 | $166.35 |
| Stockton, CA | $6,452.93 | $170.74 |
| Suburban Chicago, IL | $6,072.72 | $186.03 |
| Tennessee | $5,372.28 | $161.95 |
| Utah | $5,556.63 | $168.62 |
| Vallejo, CA | $7,737.81 | $183.13 |
| Vermont | $5,839.01 | $164.40 |
| Virgin Islands, VI | $5,967.49 | $172.51 |
| Virginia | $5,801.70 | $167.22 |
| Visalia, CA | $6,452.93 | $170.74 |
| Washington, DC area | $6,939.25 | $187.04 |
| West Virginia | $5,155.29 | $174.25 |
| Wisconsin | $5,651.39 | $160.20 |
| Wyoming | $5,900.28 | $168.35 |
| Yuba City, CA | $6,452.93 | $170.74 |
52443 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.
$5,083.54
$7,456.42
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 | $6,332.75 | 1 |
| AL | $5,176.61 | 1 |
| AR | $5,083.54 | 1 |
| AZ | $5,723.26 | 1 |
| CA | $6,452.93–$8,459.90 | 29 |
| CO | $6,271.52 | 1 |
| CT | $6,354.06 | 1 |
| DC | $6,939.25 | 1 |
| DE | $5,834.11 | 1 |
| FL | $5,658.21–$6,164.26 | 3 |
| GA | $5,284.28–$6,000.02 | 2 |
| GU | $6,688.02 | 1 |
| HI | $6,688.02 | 1 |
| IA | $5,404.73 | 1 |
| ID | $5,434.74 | 1 |
| IL | $5,411.11–$6,072.72 | 4 |
| IN | $5,475.32 | 1 |
| KS | $5,342.93 | 1 |
| KY | $5,262.72 | 1 |
| LA | $5,240.31–$5,566.05 | 2 |
| MA | $6,208.80–$7,026.54 | 2 |
| MD | $5,973.44–$6,939.25 | 3 |
| ME | $5,437.03–$5,846.70 | 2 |
| MI | $5,404.44–$5,712.94 | 2 |
| MN | $6,060.73 | 1 |
| MO | $5,107.89–$5,627.44 | 3 |
| MS | $5,098.51 | 1 |
| MT | $5,904.25 | 1 |
| NC | $5,512.27 | 1 |
| ND | $5,895.15 | 1 |
| NE | $5,450.58 | 1 |
| NH | $6,138.84 | 1 |
| NJ | $6,441.26–$6,835.82 | 2 |
| NM | $5,428.62 | 1 |
| NV | $5,907.48 | 1 |
| NY | $5,611.31–$7,015.33 | 5 |
| OH | $5,402.58 | 1 |
| OK | $5,283.67 | 1 |
| OR | $5,876.64–$6,542.53 | 2 |
| PA | $5,430.46–$6,145.91 | 2 |
| PR | $5,967.49 | 1 |
| RI | $6,095.26 | 1 |
| SC | $5,463.60 | 1 |
| SD | $5,894.08 | 1 |
| TN | $5,372.28 | 1 |
| TX | $5,384.07–$6,237.31 | 8 |
| UT | $5,556.63 | 1 |
| VA | $5,801.70–$6,939.25 | 2 |
| VI | $5,967.49 | 1 |
| VT | $5,839.01 | 1 |
| WA | $6,207.88–$7,216.85 | 2 |
| WI | $5,651.39 | 1 |
| WV | $5,155.29 | 1 |
| WY | $5,900.28 | 1 |
How the 52443 rate is calculated
Each of 52443’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 · 52443
RVUs × geographic indexes × conversion factor
Work3.62
3.62 RVUs× 1.000 GPCI
Practice expense172.69
172.69 RVUs× 1.000 GPCI
Malpractice0.46
0.46 RVUs× 1.000 GPCI
Adjusted RVUs
176.7700
Conversion factor
$33.4009
Medicare rate
$5,904.28
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 52443
The CMS indicators that decide how 52443 is paid alongside other services.
CMS payment indicators · 52443
Prostate incision
| 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
52443 without 51 · national office
$5,904.28
Prostate incision
52443-51 · Second procedure: 50%
$2,952.14
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%).
52443 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 52450Prostate incision
- 52443 identifies cystourethroscopic prostatic commissurotomy; 52450 describes transurethral incision of the prostate. Select based on the documented procedure, not just the indication.
- 52601TURP
- 52601 is for transurethral prostate resection. It is not the code for an incision-only commissurotomy.
- 52441Prostate implant
- 52441 reports placement of a transprostatic implant. It does not represent a prostatic commissurotomy.
52443 billing questions
How is this different from code 52450?
Code 52443 identifies a cystourethroscopic prostatic commissurotomy. Code 52450 describes a transurethral incision of the prostate; use the code that matches the procedure documented.
Can a related endoscopy be reported on the same date?
When related endoscopies are performed together, endoscopy family pricing applies. The operative documentation should support each reported service.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Is an assistant surgeon payable?
No. Medicare payment for an assistant at surgery is subject to a statutory restriction for this code.
What documentation supports reporting this code?
The operative report should identify the cystourethroscopic approach and the transurethral incision of the prostatic commissure. A diagnosis of urinary obstruction alone does not establish that this particular procedure was performed.
Does the code include same-day postoperative care?
Yes. The code has a 0-day global period, and same-day preoperative and postoperative care is included.
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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