No office rate
52235 is for the medium-size tumor category; 52240 is for tumors over 5 cm. Base the selection on the documented tumor size and operative findings.
On this page
CMS RVU26D · Effective 2026-10-01
52240 Bladder tumor treatment Medicare reimbursement rates in California
Reports endoscopic removal or destruction of a large bladder tumor, with selection based on the documented tumor size and treatment performed. Compare 52240 office and facility rates across CMS payment localities in California.
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.
What does Medicare pay for 52240 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$340.36–$386.76
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $46.40 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 52240 pays more and less in California
Urology
About 52240: Large bladder tumor endoscopic treatment
Reports endoscopic removal or destruction of a large bladder tumor, with selection based on the documented tumor size and treatment performed.
A urologist performs this service through a cystoscope to remove or destroy a large bladder tumor, commonly using a resection instrument, cautery, or laser. It is typically performed in a facility operating room, although selected cases may be treated in an office setting. The procedure treats the tumor rather than merely obtaining a diagnostic tissue sample, and removed tissue may be submitted for pathologic examination.
Choose this code when the operative findings and documentation support the large-tumor size category; record the tumor size and whether it was resected, fulgurated, or treated by another method covered by the code. Medicare 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 anatomy. Medicare does not pay an assistant at surgery under the statutory restriction, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 52240
- 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 RVU7.31 · 71%
- Practice expense (office) RVU2.05 · 20%
- Malpractice RVU0.95 · 9%
20.7K
Medicare services in 2024 · #1135 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.
52240 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
52234 represents the small-tumor category, while 52240 represents the large-tumor category. The treatment method alone does not establish the size level.
$376.47–$474.12
52204 reports cystoscopic biopsy for diagnostic sampling. Use 52240 when the service includes treatment of a large bladder tumor rather than biopsy alone.
Compare 52240 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $343.17 |
| Chico | Office Unavailable | Facility $340.36 |
| El Centro | Office Unavailable | Facility $340.52 |
| Fresno | Office Unavailable | Facility $340.36 |
| Hanford-Corcoran | Office Unavailable | Facility $340.36 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $356.24 |
| Madera | Office Unavailable | Facility $340.36 |
| Merced | Office Unavailable | Facility $340.36 |
| Modesto | Office Unavailable | Facility $340.36 |
| Napa | Office Unavailable | Facility $365.91 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $351.70 |
| Redding | Office Unavailable | Facility $340.36 |
| Rest Of California | Office Unavailable | Facility $340.36 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $350.67 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $349.59 |
| Salinas | Office Unavailable | Facility $348.10 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $350.58 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $378.47 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $377.39 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $386.76 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $382.35 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $343.31 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $349.49 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $347.84 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $352.58 |
| Stockton | Office Unavailable | Facility $340.36 |
| Vallejo | Office Unavailable | Facility $364.35 |
| Visalia | Office Unavailable | Facility $340.36 |
| Yuba City | Office Unavailable | Facility $340.36 |
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52240 billing questions
How is this code distinguished from 52235?
Use the large-tumor category for tumors over 5 cm; 52235 represents the medium-size category. The operative report should support the size classification.
When would 52204 be more appropriate?
52204 is for cystoscopic biopsy when the service is diagnostic sampling rather than the large-tumor treatment reported here.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this service.
How are related endoscopies paid in the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together, so payment is coordinated under that pricing rule.
What documentation supports reporting this code?
Document the tumor size, cystoscopic findings, and treatment performed, such as resection or fulguration. The record should support the large-tumor category.
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.
6,11352224,,Cystoscopy and treatment,A,,3.95,18.32,,0.82,,0.49,22.76,5.26,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11452234,,Cystoscopy and treatment,A,,4.50,1.42,NA,1.42,,0.57,6.49,6.49,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11552235,,Cystoscopy and treatment,A,,5.30,1.64,NA,1.64,,0.68,7.62,7.62,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11652240,,Cystoscopy and treatment,A,,7.31,2.05,NA,2.05,,0.95,10.31,10.31,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11752250,,Cystoscopy and radiotracer,A,,4.38,1.40,NA,1.40,,0.56,6.34,6.34,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11852260,,Cystoscopy and treatment,A,,3.81,1.24,NA,1.24,,0.51,5.56,5.56,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11952265,,Cystoscopy and treatment,A,,2.87,7.05,,1.03,,0.42,10.34,4.32,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00