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CMS RVU26D · Effective 2026-10-01

52285 in Chicago

Office / nonfacility

$348.97

Base rate per service

Facility setting

$195.56

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Urology procedure

About 52285: Female urethral meatotomy with cystoscopy

Cystourethroscopy with incision of a narrowed female urethral opening, reported when the surgeon treats meatal narrowing rather than performing dilation alone.

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.

CMS billing rules for 52285

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Endoscopy family pricing applies when related endoscopies are performed together.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.51 · 36%
  • Practice expense (office) RVU5.76 · 59%
  • Malpractice RVU0.49 · 5%

1.3K

Medicare services in 2024 · #2801 by national volume

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.

52285 compared with similar codes

Office rates for Chicago, from the same CMS release.

52270

Urethrotomy

Female urethra

$420.55

This code is for female urethral meatotomy; 52270 is the male counterpart.

52275

Urethrotomy

Female urethral stricture incision

$546.94

52275 describes internal urethrotomy, a different incision procedure. Use 52285 when the documented treatment is female urethral meatotomy.

52281

Urethral dilation

Cystoscopic stricture treatment

$327.54

52281 covers urethral calibration or dilation. It is not the code for an incision of the female urethral meatus.

The same code, a different location

How does Chicago compare?

In East St. Louis, the office rate for 52285 is $327.20—$21.77 lower than the $348.97 rate in Chicago. Both use the same code, release and participation basis.

52285 across payment areas

Same release and payment basis · bars start at $0

  1. Chicago · This locality

    $348.97

  2. $21.77 lower than Chicago

  3. $30.50 lower than Chicago

  4. $4.33 lower than Chicago

  5. $11.54 higher than Chicago

  6. $19.45 higher than Chicago

  7. Miami

    $358.91

    $9.94 higher than Chicago

Other payment areas listed in Illinois appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 52285 ranges from $290.93 in Arkansas to $416.33 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas
  • Manhattan

    New York · 52285

    Office

    $374.25

    Facility

    $196.88

    $25.28 higher than Chicago for the office setting.

  • Alaska*

    Alaska · 52285

    Office

    $389.77

    Facility

    $227.20

    $40.80 higher than Chicago for the office setting.

  • Alabama

    Alabama · 52285

    Office

    $294.84

    Facility

    $161.28

    $54.13 lower than Chicago for the office setting.

  • Arkansas

    Arkansas · 52285

    Office

    $290.93

    Facility

    $159.81

    $58.04 lower than Chicago for the office setting.

  • Arizona

    Arizona · 52285

    Office

    $317.67

    Facility

    $169.76

    $31.30 lower than Chicago for the office setting.

  • Bakersfield

    California · 52285

    Office

    $340.29

    Facility

    $172.99

    $8.68 lower than Chicago for the office setting.

  • Chico

    California · 52285

    Office

    $338.86

    Facility

    $171.57

    $10.11 lower than Chicago for the office setting.

  • El Centro

    California · 52285

    Office

    $338.94

    Facility

    $171.65

    $10.03 lower than Chicago for the office setting.

  • Fresno

    California · 52285

    Office

    $338.86

    Facility

    $171.57

    $10.11 lower than Chicago for the office setting.

  • Hanford-Corcoran

    California · 52285

    Office

    $338.86

    Facility

    $171.57

    $10.11 lower than Chicago for the office setting.

  • Madera

    California · 52285

    Office

    $338.86

    Facility

    $171.57

    $10.11 lower than Chicago for the office setting.

  • Merced

    California · 52285

    Office

    $338.86

    Facility

    $171.57

    $10.11 lower than Chicago for the office setting.

  • Modesto

    California · 52285

    Office

    $338.86

    Facility

    $171.57

    $10.11 lower than Chicago for the office setting.

  • Napa

    California · 52285

    Office

    $386.51

    Facility

    $185.32

    $37.54 higher than Chicago for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 52285

    Office

    $358.12

    Facility

    $177.70

    $9.15 higher than Chicago for the office setting.

  • Redding

    California · 52285

    Office

    $338.86

    Facility

    $171.57

    $10.11 lower than Chicago for the office setting.

  • Rest Of California

    California · 52285

    Office

    $338.86

    Facility

    $171.57

    $10.11 lower than Chicago for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 52285

    Office

    $344.17

    Facility

    $176.87

    $4.80 lower than Chicago for the office setting.

  • Sacramento-Roseville-Folsom

    California · 52285

    Office

    $353.98

    Facility

    $176.46

    $5.01 higher than Chicago for the office setting.

  • Salinas

    California · 52285

    Office

    $352.62

    Facility

    $175.71

    $3.65 higher than Chicago for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 52285

    Office

    $359.72

    Facility

    $177.16

    $10.75 higher than Chicago for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 52285

    Office

    $407.16

    Facility

    $191.93

    $58.19 higher than Chicago for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 52285

    Office

    $406.60

    Facility

    $191.37

    $57.63 higher than Chicago for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 52285

    Office

    $416.33

    Facility

    $196.22

    $67.36 higher than Chicago for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 52285

    Office

    $414.06

    Facility

    $193.95

    $65.09 higher than Chicago for the office setting.

  • San Luis Obispo-Paso Robles

    California · 52285

    Office

    $347.13

    Facility

    $173.27

    $1.84 lower than Chicago for the office setting.

  • Santa Cruz-Watsonville

    California · 52285

    Office

    $362.22

    Facility

    $176.76

    $13.25 higher than Chicago for the office setting.

  • Santa Maria-Santa Barbara

    California · 52285

    Office

    $353.62

    Facility

    $175.64

    $4.65 higher than Chicago for the office setting.

  • Santa Rosa-Petaluma

    California · 52285

    Office

    $365.78

    Facility

    $178.34

    $16.81 higher than Chicago for the office setting.

  • Stockton

    California · 52285

    Office

    $338.86

    Facility

    $171.57

    $10.11 lower than Chicago for the office setting.

  • Vallejo

    California · 52285

    Office

    $385.70

    Facility

    $184.52

    $36.73 higher than Chicago for the office setting.

  • Visalia

    California · 52285

    Office

    $338.86

    Facility

    $171.57

    $10.11 lower than Chicago for the office setting.

  • Yuba City

    California · 52285

    Office

    $338.86

    Facility

    $171.57

    $10.11 lower than Chicago for the office setting.

  • Colorado

    Colorado · 52285

    Office

    $336.13

    Facility

    $173.72

    $12.84 lower than Chicago for the office setting.

  • Connecticut

    Connecticut · 52285

    Office

    $346.59

    Facility

    $182.19

    $2.38 lower than Chicago for the office setting.

  • Delaware

    Delaware · 52285

    Office

    $322.62

    Facility

    $171.81

    $26.35 lower than Chicago for the office setting.

  • Fort Lauderdale

    Florida · 52285

    Office

    $341.72

    Facility

    $187.09

    $7.25 lower than Chicago for the office setting.

  • Rest Of Florida

    Florida · 52285

    Office

    $325.76

    Facility

    $179.83

    $23.21 lower than Chicago for the office setting.

  • Atlanta

    Georgia · 52285

    Office

    $332.71

    Facility

    $177.63

    $16.26 lower than Chicago for the office setting.

  • Rest Of Georgia

    Georgia · 52285

    Office

    $308.36

    Facility

    $172.20

    $40.61 lower than Chicago for the office setting.

  • Hawaii, Guam

    Hawaii · 52285

    Office

    $345.46

    Facility

    $171.91

    $3.51 lower than Chicago for the office setting.

  • Iowa

    Iowa · 52285

    Office

    $299.77

    Facility

    $160.10

    $49.20 lower than Chicago for the office setting.

  • Idaho

    Idaho · 52285

    Office

    $301.98

    Facility

    $161.55

    $46.99 lower than Chicago for the office setting.

  • Indiana

    Indiana · 52285

    Office

    $303.54

    Facility

    $162.04

    $45.43 lower than Chicago for the office setting.

  • Kansas

    Kansas · 52285

    Office

    $299.41

    Facility

    $161.42

    $49.56 lower than Chicago for the office setting.

  • Kentucky

    Kentucky · 52285

    Office

    $303.25

    Facility

    $167.55

    $45.72 lower than Chicago for the office setting.

  • New Orleans

    Louisiana · 52285

    Office

    $316.87

    Facility

    $173.23

    $32.10 lower than Chicago for the office setting.

  • Rest Of Louisiana

    Louisiana · 52285

    Office

    $303.18

    Facility

    $168.09

    $45.79 lower than Chicago for the office setting.

  • Metropolitan Boston

    Massachusetts · 52285

    Office

    $366.32

    Facility

    $184.07

    $17.35 higher than Chicago for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 52285

    Office

    $334.74

    Facility

    $174.01

    $14.23 lower than Chicago for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 52285

    Office

    $345.79

    Facility

    $182.01

    $3.18 lower than Chicago for the office setting.

  • Rest Of Maryland

    Maryland · 52285

    Office

    $328.13

    Facility

    $173.66

    $20.84 lower than Chicago for the office setting.

  • Rest Of Maine

    Maine · 52285

    Office

    $304.42

    Facility

    $163.98

    $44.55 lower than Chicago for the office setting.

  • Southern Maine

    Maine · 52285

    Office

    $318.22

    Facility

    $166.95

    $30.75 lower than Chicago for the office setting.

  • Detroit

    Michigan · 52285

    Office

    $330.49

    Facility

    $183.19

    $18.48 lower than Chicago for the office setting.

  • Rest Of Michigan

    Michigan · 52285

    Office

    $311.37

    Facility

    $172.00

    $37.60 lower than Chicago for the office setting.

  • Minnesota

    Minnesota · 52285

    Office

    $320.05

    Facility

    $162.98

    $28.92 lower than Chicago for the office setting.

  • Metropolitan Kansas City

    Missouri · 52285

    Office

    $313.88

    Facility

    $170.55

    $35.09 lower than Chicago for the office setting.

  • Metropolitan St. Louis

    Missouri · 52285

    Office

    $316.79

    Facility

    $171.48

    $32.18 lower than Chicago for the office setting.

  • Rest Of Missouri

    Missouri · 52285

    Office

    $299.02

    Facility

    $167.44

    $49.95 lower than Chicago for the office setting.

  • Mississippi

    Mississippi · 52285

    Office

    $294.98

    Facility

    $163.55

    $53.99 lower than Chicago for the office setting.

  • Montana**

    Montana · 52285

    Office

    $325.96

    Facility

    $173.32

    $23.01 lower than Chicago for the office setting.

  • North Carolina

    North Carolina · 52285

    Office

    $307.19

    Facility

    $164.78

    $41.78 lower than Chicago for the office setting.

  • North Dakota**

    North Dakota · 52285

    Office

    $316.27

    Facility

    $163.63

    $32.70 lower than Chicago for the office setting.

  • Nebraska

    Nebraska · 52285

    Office

    $301.00

    Facility

    $160.11

    $47.97 lower than Chicago for the office setting.

  • New Hampshire

    New Hampshire · 52285

    Office

    $331.83

    Facility

    $172.93

    $17.14 lower than Chicago for the office setting.

  • Northern Nj

    New Jersey · 52285

    Office

    $365.27

    Facility

    $188.21

    $16.30 higher than Chicago for the office setting.

  • Rest Of New Jersey

    New Jersey · 52285

    Office

    $349.97

    Facility

    $183.28

    $1.00 higher than Chicago for the office setting.

  • New Mexico

    New Mexico · 52285

    Office

    $313.31

    Facility

    $173.34

    $35.66 lower than Chicago for the office setting.

  • Nevada**

    Nevada · 52285

    Office

    $323.45

    Facility

    $170.66

    $25.52 lower than Chicago for the office setting.

  • Nyc Suburbs/Long Island

    New York · 52285

    Office

    $383.88

    Facility

    $202.39

    $34.91 higher than Chicago for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 52285

    Office

    $352.98

    Facility

    $185.84

    $4.01 higher than Chicago for the office setting.

  • Queens

    New York · 52285

    Office

    $375.74

    Facility

    $195.32

    $26.77 higher than Chicago for the office setting.

  • Rest Of New York

    New York · 52285

    Office

    $311.51

    Facility

    $166.50

    $37.46 lower than Chicago for the office setting.

  • Ohio

    Ohio · 52285

    Office

    $309.39

    Facility

    $170.02

    $39.58 lower than Chicago for the office setting.

  • Oklahoma

    Oklahoma · 52285

    Office

    $301.76

    Facility

    $165.45

    $47.21 lower than Chicago for the office setting.

  • Portland

    Oregon · 52285

    Office

    $345.03

    Facility

    $175.45

    $3.94 lower than Chicago for the office setting.

  • Rest Of Oregon

    Oregon · 52285

    Office

    $320.36

    Facility

    $168.33

    $28.61 lower than Chicago for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 52285

    Office

    $339.15

    Facility

    $180.25

    $9.82 lower than Chicago for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 52285

    Office

    $309.32

    Facility

    $169.19

    $39.65 lower than Chicago for the office setting.

  • Puerto Rico

    Puerto Rico · 52285

    Office

    $327.86

    Facility

    $173.54

    $21.11 lower than Chicago for the office setting.

  • Rhode Island

    Rhode Island · 52285

    Office

    $332.80

    Facility

    $175.12

    $16.17 lower than Chicago for the office setting.

  • South Carolina

    South Carolina · 52285

    Office

    $308.92

    Facility

    $167.87

    $40.05 lower than Chicago for the office setting.

  • South Dakota**

    South Dakota · 52285

    Office

    $315.13

    Facility

    $162.48

    $33.84 lower than Chicago for the office setting.

  • Tennessee

    Tennessee · 52285

    Office

    $300.91

    Facility

    $162.16

    $48.06 lower than Chicago for the office setting.

  • Austin

    Texas · 52285

    Office

    $335.52

    Facility

    $174.02

    $13.45 lower than Chicago for the office setting.

  • Beaumont

    Texas · 52285

    Office

    $307.52

    Facility

    $168.61

    $41.45 lower than Chicago for the office setting.

  • Brazoria

    Texas · 52285

    Office

    $321.60

    Facility

    $170.33

    $27.37 lower than Chicago for the office setting.

  • Dallas

    Texas · 52285

    Office

    $323.95

    Facility

    $171.92

    $25.02 lower than Chicago for the office setting.

  • Fort Worth

    Texas · 52285

    Office

    $322.24

    Facility

    $171.74

    $26.73 lower than Chicago for the office setting.

  • Galveston

    Texas · 52285

    Office

    $322.77

    Facility

    $171.20

    $26.20 lower than Chicago for the office setting.

  • Houston

    Texas · 52285

    Office

    $331.74

    Facility

    $180.16

    $17.23 lower than Chicago for the office setting.

  • Rest Of Texas

    Texas · 52285

    Office

    $314.59

    Facility

    $169.74

    $34.38 lower than Chicago for the office setting.

  • Utah

    Utah · 52285

    Office

    $312.78

    Facility

    $169.30

    $36.19 lower than Chicago for the office setting.

  • Virginia

    Virginia · 52285

    Office

    $317.91

    Facility

    $167.86

    $31.06 lower than Chicago for the office setting.

  • Virgin Islands

    United States Virgin Islands · 52285

    Office

    $327.86

    Facility

    $173.54

    $21.11 lower than Chicago for the office setting.

  • Vermont

    Vermont · 52285

    Office

    $315.98

    Facility

    $164.87

    $32.99 lower than Chicago for the office setting.

  • Rest Of Washington

    Washington · 52285

    Office

    $333.80

    Facility

    $173.07

    $15.17 lower than Chicago for the office setting.

  • Seattle (King Cnty)

    Washington · 52285

    Office

    $372.53

    Facility

    $185.24

    $23.56 higher than Chicago for the office setting.

  • Wisconsin

    Wisconsin · 52285

    Office

    $306.59

    Facility

    $160.36

    $42.38 lower than Chicago for the office setting.

  • West Virginia

    West Virginia · 52285

    Office

    $307.84

    Facility

    $175.20

    $41.13 lower than Chicago for the office setting.

  • Wyoming**

    Wyoming · 52285

    Office

    $321.74

    Facility

    $169.10

    $27.23 lower than Chicago for the office setting.

See how rates vary across the country

52285 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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 all state and territory rates as a table
State / territoryRate rangeLocalities
AK$389.771
AL$294.841
AR$290.931
AZ$317.671
CA$338.86–$416.3329
CO$336.131
CT$346.591
DC$368.421
DE$322.621
FL$325.76–$358.913
GA$308.36–$332.712
GU$345.461
HI$345.461
IA$299.771
ID$301.981
IL$318.47–$348.974
IN$303.541
KS$299.411
KY$303.251
LA$303.18–$316.872
MA$334.74–$366.322
MD$328.13–$368.423
ME$304.42–$318.222
MI$311.37–$330.492
MN$320.051
MO$299.02–$316.793
MS$294.981
MT$325.961
NC$307.191
ND$316.271
NE$301.001
NH$331.831
NJ$349.97–$365.272
NM$313.311
NV$323.451
NY$311.51–$383.885
OH$309.391
OK$301.761
OR$320.36–$345.032
PA$309.32–$339.152
PR$327.861
RI$332.801
SC$308.921
SD$315.131
TN$300.911
TX$307.52–$335.528
UT$312.781
VA$317.91–$368.422
VI$327.861
VT$315.981
WA$333.80–$372.532
WI$306.591
WV$307.841
WY$321.741

Explore 52285 on the national rate map →

Where does this rate apply?

Chicago is a Medicare payment area. Our Census mapping connects it to 137 cities and communities in Illinois, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Why are the office and facility amounts different?

For 52285 in Chicago, the physician’s office rate is $348.97 and the facility-setting rate is $195.56: a difference of $153.41.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 52285 in Chicago. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$383.87

$348.97 × 110% = $383.87

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 52285 in Chicago.

PPRRVU2026_Oct_nonQPP.csv

6,128

Code
52285
Physician work
3.51
Practice expense
5.76
Malpractice
0.49

GPCI2026.csv

48

Locality
Chicago
Physician work
1.007
Practice expense
1.005
Malpractice
2.295
Office / nonfacility calculation for 52285 in Chicago
ComponentRVULocality factorAdjusted
Physician work3.51× 1.0073.5346
Practice expense5.76× 1.0055.7888
Malpractice0.49× 2.2951.1245
Total RVUs10.4479
Conversion factor× 33.4009

Office / nonfacility rate, Chicago$348.97

Open 52285 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.511.007
Practice expense5.761.005
Malpractice0.492.295

(3.51 × 1.007 + 5.76 × 1.005 + 0.49 × 2.295) × $33.4009 = $348.97

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.511.007
Practice expense1.191.005
Malpractice0.492.295

(3.51 × 1.007 + 1.19 × 1.005 + 0.49 × 2.295) × $33.4009 = $195.56

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

52285 · Office / nonfacility

$348.97

Effective 2026-10-01

The base rate is $5.16 higher than on 2025-10-01, moving from $343.81 to $348.97 (1.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $343.81changed to$348.97

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.60 changed to 3.51
    • Practice expense RVU 5.86 changed to 5.76
    • Malpractice RVU 0.50 changed to 0.49
    • Practice expense GPCI 1.023 changed to 1.005
    • Malpractice GPCI 2.018 changed to 2.295

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $343.81

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$348.97$195.56RVU26D
2026-07-01$348.97$195.56RVU26C
2026-04-01$348.97$195.56RVU26B
2026-01-01$348.97$195.56RVU26A
2025-10-01$343.81$208.47RVU25D
2025-07-01$343.81$208.47RVU25C
2025-04-01$343.81$208.47RVU25B
2025-01-01$343.81$208.47RVU25A

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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 52285PPRRVU2026_Oct_nonQPP.csv, line 6,128 (RVU26D)
Geographic factors for ChicagoGPCI2026.csv, line 48 (RVU26D)