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Billing code 52649: Laser enucleationMedicare rate & RVUs

Reports complete laser enucleation of prostate tissue to relieve benign prostatic obstruction, with removed tissue retrieved for examination.

CMS RVU26DEffective Oct 1, 2026109 payment localities10.1K Medicare services in 2024

Medicare pays $657.00 for 52649 nationally in a facility.

Medicare rate · 52649

Laser enucleation

Swap in your local Medicare rate.

Work RVUs
12.68
Total RVUs
19.67
Global days
090

National rate · 2026

$657.00

Facility setting, before claim adjustments.

See every locality for 52649 → · 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 52649 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 52649 covers

A urologist performs this endoscopic operation for obstructive enlargement of the prostate, commonly in a hospital operating room or ambulatory surgery setting. Laser energy separates obstructing prostate tissue from the surrounding surgical capsule; the freed tissue is typically fragmented and removed from the bladder for pathologic examination. The operation is distinct from vaporizing prostate tissue or resecting it in chips.

Select this code when the operative report supports complete laser enucleation, rather than vaporization or resection. Document the indication, laser enucleation technique, extent of tissue removal, and any tissue retrieval. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Report the service once; modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity. 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 52649 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

52649 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$610.99
Alaska*Unavailable$855.95
ArizonaUnavailable$643.61
ArkansasUnavailable$605.35
AtlantaUnavailable$672.07
AustinUnavailable$662.02
BakersfieldUnavailable$660.94
Baltimore/Surr. CntysUnavailable$689.74
BeaumontUnavailable$637.02
BrazoriaUnavailable$646.80

52649 rates by state

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

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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
52649 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 52649 rate is calculated

Each of 52649’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 · 52649

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 12.68Practice expense 5.36Malpractice 1.63

19.6700 adjusted RVUs×$33.4009 conversion factor=$657.00

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

Payment rules and modifiers for 52649

52649 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 52649

Laser enucleation

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.08/0.83/0.09Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 52649

Laser enucleation

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

52649 without 51 · national facility

$657.00

Laser enucleation

52649-51 · Second procedure: 50%

$328.50

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

52649 compared with similar codes

Compare codes

52649 vs 52648 vs 52601 vs 52630: national Medicare rates

Swap in your local Medicare rate.

  • 52649
    Laser enucleation · 12.68 wRVU
    —
  • 52648
    Laser prostate surgery · 9.8 wRVU
    —
  • 52601
    TURP · 9.75 wRVU
    —
  • 52630
    Prostate resection · 6.39 wRVU
    —

How to choose

52648Laser prostate surgery
Choose 52649 for laser enucleation with tissue removal; choose 52648 when laser energy vaporizes the obstructing tissue.
52601TURP
52601 represents transurethral resection of prostate tissue. 52649 is selected when the surgeon performs complete laser enucleation instead.
52630Prostate resection
52630 addresses transurethral removal of prostate regrowth after prior surgery; 52649 describes complete laser enucleation, not treatment defined by regrowth.

Codes related to 52649

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

Codes related to 52649
CodeHow it relatesNational office range
Used instead
52648Laser prostate surgeryLaser vaporization treats obstructing prostate tissue without complete enucleation.No office rate
52601TURPTURP removes obstructing tissue by resection rather than laser enucleation.No office rate
52630Prostate resectionUsed for transurethral treatment of prostate regrowth after prior prostate surgery.No office rate

52649 billing questions

How is 52649 distinguished from laser vaporization?

52649 describes enucleating and removing prostate tissue. Use the vaporization code when the operative technique vaporizes tissue rather than freeing and removing it.

Is morcellation separately reported?

No. Fragmenting and retrieving the enucleated tissue is part of the complete enucleation service when performed.

Can modifier 50 be appended?

No. Report the prostate enucleation once; bilateral adjustment is inappropriate for this service.

What documentation supports 52649?

The operative report should identify the laser enucleation technique, the obstructive indication, and the extent of tissue enucleated and retrieved.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and additional procedures are subject to the standard multiple-procedure reduction.

When is assistant-at-surgery payment allowed?

Only when the record documents the medical necessity of the assistant. Co-surgeon and team-surgery payment is 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 52649PPRRVU2026_Oct_nonQPP.csv, line 6,169 (RVU26D)

Open CMS sourceHow we calculate rates

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