No office rate
Use 52450 for outlet relief by prostate incision without tissue removal. Use 52601 when prostate tissue is resected.
On this page
CMS RVU26D · Effective 2026-10-01
52450 Prostate incision Medicare reimbursement rates in Colorado
A urologist incises prostate tissue to relieve urinary outlet obstruction, typically when a limited endoscopic incision is chosen instead of tissue removal. Compare 52450 office and facility rates across CMS payment localities in Colorado.
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 52450 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$443.37
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
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.
Urology procedure
About 52450: Transurethral prostate incision
A urologist incises prostate tissue to relieve urinary outlet obstruction, typically when a limited endoscopic incision is chosen instead of tissue removal.
A urologist performs this endoscopic procedure to open the urinary channel by making incisions in prostate tissue, rather than removing prostate tissue. It is used for benign prostatic obstruction when the clinician expects incisions to improve flow, often with a relatively small prostate and no prominent median lobe. The procedure is generally performed in an operating room with anesthesia, using an endoscope passed through the urethra.
Report the service when the operative note supports an incision of the prostate to relieve obstruction; distinguish it from resection or vaporization procedures that remove or destroy tissue. Endoscopic visualization and access used to perform the incision are part of the operative service. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 52450
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- 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 RVU7.59 · 58%
- Practice expense (office) RVU4.53 · 35%
- Malpractice RVU0.99 · 8%
960
Medicare services in 2024 · #3003 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.
52450 compared with similar codes
Office rates for Colorado, from the same CMS release.
$1,313.57
52441 places a transprostatic implant to hold the outlet open; 52450 relieves obstruction by incising prostate tissue.
No office rate
52500 addresses obstruction at the bladder neck. Use 52450 when the operative incision is in the prostate.
Compare 52450 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.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$443.37
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 52450 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
6,161
- Code
- 52450
- Physician work
- 7.59
- Practice expense
- 4.53
- Malpractice
- 0.99
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.59 | × 1.012 | 7.6811 |
| Practice expense | 4.53 | × 1.064 | 4.8199 |
| Malpractice | 0.99 | × 0.781 | 0.7732 |
| Total RVUs | 13.2742 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$443.37
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.59 | 1.012 |
| Practice expense | 4.53 | 1.064 |
| Malpractice | 0.99 | 0.781 |
(7.59 × 1.012 + 4.53 × 1.064 + 0.99 × 0.781) × $33.4009 = $443.37
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.
52450 billing questions
How does this differ from transurethral prostate resection?
This procedure opens the outlet with incisions and does not remove prostate tissue. A resection code is used when prostate tissue is actually removed.
Can diagnostic cystoscopy be billed separately?
Do not separately report cystoscopy when endoscopic visualization is performed as part of the prostate incision.
Should modifier 50 be used for incisions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this code. Co-surgeon and team-surgery billing are 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 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.
6,15852441,,Cysto insj trnsprstc 1 implt,A,,3.90,32.90,,1.13,,0.48,37.28,5.51,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,15952442,,Cysto ins trnsprstc implt ea,A,,0.98,24.77,,0.21,,0.13,25.88,1.32,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,16052443,,Cysto 1st trurl prst8 comis,A,,3.62,172.69,,1.08,,0.46,176.77,5.16,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,16152450,,Transurethral inc prostate,A,,7.59,4.53,NA,4.53,,0.99,13.11,13.11,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,16252500,,Trurl resection bladder neck,A,,5.85,3.94,NA,3.94,,0.76,10.55,10.55,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,1635250F,,Asthma discharge plan presnt,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
6,16452597,,Trurl rbtc wtrjt rescj prst8,A,,10.25,4.85,NA,4.85,,1.32,16.42,16.42,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899