$1,231.03
52441 represents the first implant in the session; 52442 represents each additional implant and is reported with 52441.
On this page
CMS RVU26D · Effective 2026-10-01
52442 Prostatic implant Medicare reimbursement rates in Delaware
Report this add-on for each additional implant placed during cystoscopic prostatic urethral lift treatment for obstructive symptoms from benign prostatic enlargement. Compare 52442 office and facility rates across CMS payment localities in Delaware.
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 52442 in Delaware?
Delaware 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
$854.21
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$43.73
1 of 1 localities have a supported rate.
Payment area: Delaware
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 52442: Additional prostatic urethral lift implant
Report this add-on for each additional implant placed during cystoscopic prostatic urethral lift treatment for obstructive symptoms from benign prostatic enlargement.
During cystoscopy, the urologist places small implants through the urethra to hold obstructing prostate tissue away from the urinary channel. This code represents an implant beyond the first one placed during the same treatment session. Prostatic urethral lift is used to treat urinary symptoms associated with benign prostatic enlargement; the service may be performed in an office or facility setting.
Report this code only with the primary implant-placement procedure, 52441, and count each additional implant separately. The operative note should support the indication, the cystoscopic treatment, and the number of implants placed so the first implant and additional implants can be distinguished. CMS classifies this as an add-on code paid within the primary procedure’s global period. It cannot be reported by itself.
CMS billing rules for 52442
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.98 · 4%
- Practice expense (office) RVU24.77 · 96%
- Malpractice RVU0.13 · 1%
57.5K
Medicare services in 2024 · #727 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.
52442 compared with similar codes
Office rates for Delaware, from the same CMS release.
$3,355.84
53854 describes water vapor thermal treatment of prostate tissue, not placement of implants to retract obstructing tissue.
No office rate
52601 is transurethral resection of prostate tissue. Choose it for resection rather than a prostatic urethral lift.
Compare 52442 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
Delaware →
Office / nonfacility
$854.21
Facility
$43.73
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 52442 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
6,159
- Code
- 52442
- Physician work
- 0.98
- Practice expense
- 24.77
- Malpractice
- 0.13
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.98 | × 1.005 | 0.9849 |
| Practice expense | 24.77 | × 0.988 | 24.4728 |
| Malpractice | 0.13 | × 0.899 | 0.1169 |
| Total RVUs | 25.5745 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$854.21
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.98 | 1.005 |
| Practice expense | 24.77 | 0.988 |
| Malpractice | 0.13 | 0.899 |
(0.98 × 1.005 + 24.77 × 0.988 + 0.13 × 0.899) × $33.4009 = $854.21
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.98 | 1.005 |
| Practice expense | 0.21 | 0.988 |
| Malpractice | 0.13 | 0.899 |
(0.98 × 1.005 + 0.21 × 0.988 + 0.13 × 0.899) × $33.4009 = $43.73
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.
52442 billing questions
When should 52442 be reported instead of 52441?
Use 52441 for the first implant placed during the session. Report 52442 for each implant placed after that first one.
Can 52442 be billed without 52441?
No. It is an add-on code and must be reported with the primary implant-placement code, 52441.
How should the number of additional implants be documented?
The procedure note should state the total number of implants placed and support which implant was the first and which were additional.
Is 52442 paid outside the primary procedure’s global period?
No. CMS identifies it as an add-on code paid within the global period of the primary procedure.
How does this treatment differ from water vapor therapy?
Prostatic urethral lift uses implants to retract obstructing tissue. Water vapor therapy, reported with 53854, treats prostate tissue with thermal energy.
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.
6,15652400,,Cysto cgen post urtl valves,A,,8.47,3.26,NA,3.26,,1.09,12.82,12.82,0,090,0.08,0.83,0.09,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,15752402,,Cysto trurl rescj ejacul dux,A,,5.14,1.12,NA,1.12,,0.65,6.91,6.91,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,15852441,,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
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503