Billing code 52240: Bladder tumor treatmentMedicare rate & RVUs in Florida
Reports endoscopic removal or destruction of a large bladder tumor, with selection based on the documented tumor size and treatment performed.
CMS doesn’t publish an office rate for 52240 in Florida.
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 52240 covers
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.
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.
Where 52240 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $370.89 |
| Miami | Unavailable | $395.69 |
| Rest Of Florida | Unavailable | $357.31 |
How the 52240 rate is calculated
Each of 52240’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 · 52240
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.31Practice expense 2.05Malpractice 0.95
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 52240
The CMS indicators that decide how 52240 is paid alongside other services.
CMS payment indicators · 52240
Bladder tumor treatment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
52240 without 51 · national facility
$344.36
Bladder tumor treatment
52240-51 · Second procedure: 50%
$172.18
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%).
52240 compared with similar codes
Compare codes
52240 vs 52235 vs 52234 vs 52204: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 52235Bladder tumor resection
- 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.
- 52234Bladder tumor treatment
- 52234 represents the small-tumor category, while 52240 represents the large-tumor category. The treatment method alone does not establish the size level.
- 52204Cystoscopic biopsy
- 52204 reports cystoscopic biopsy for diagnostic sampling. Use 52240 when the service includes treatment of a large bladder tumor rather than biopsy alone.
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 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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