Billing code 52450: Prostate incisionMedicare rate & RVUs in Delaware
A urologist incises prostate tissue to relieve urinary outlet obstruction, typically when a limited endoscopic incision is chosen instead of tissue removal.
CMS doesn’t publish an office rate for 52450 in Delaware.
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 9 sections
What 52450 covers
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.
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 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $434.00 |
How the 52450 rate is calculated
Each of 52450’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 · 52450
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.59Practice expense 4.53Malpractice 0.99
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 52450
52450 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 52450
Prostate incision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.08/0.83/0.09 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 52450
Prostate incision
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
52450 without 51 · national facility
$437.89
Prostate incision
52450-51 · Second procedure: 50%
$218.95
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%).
52450 compared with similar codes
Compare codes
52450 vs 52601 vs 52441 vs 52500: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 52601TURP
- Use 52450 for outlet relief by prostate incision without tissue removal. Use 52601 when prostate tissue is resected.
- 52441Prostate implant
- 52441 places a transprostatic implant to hold the outlet open; 52450 relieves obstruction by incising prostate tissue.
- 52500Bladder neck resection
- 52500 addresses obstruction at the bladder neck. Use 52450 when the operative incision is in the prostate.
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 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
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