Billing code 52640: Bladder neck treatmentMedicare rate & RVUs in Florida
Endoscopic treatment of scar narrowing at the bladder neck, reported when a contracture obstructs the outlet and requires operative correction.
CMS doesn’t publish an office rate for 52640 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 52640 covers
Code 52640 represents endoscopic operative treatment of a scarred, narrowed bladder neck, generally using a resectoscope to cut or remove contracture tissue and reopen the outlet. Urologists commonly treat this after prior prostate or bladder-neck surgery. The procedure is performed in an operating room, usually under anesthesia, when obstruction is attributable to the bladder-neck scar rather than recurrent prostate tissue or a urethral stricture.
Report 52640 for treatment of the contracture, not simply cystoscopic inspection. The operative report should identify the bladder-neck narrowing, the treatment performed, and relevant prior surgery. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures subject to multiple-procedure payment are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; 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 52640 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 | $319.85 |
| Miami | Unavailable | $337.60 |
| Rest Of Florida | Unavailable | $306.62 |
How the 52640 rate is calculated
Each of 52640’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 · 52640
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.67Practice expense 3.79Malpractice 0.59
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 52640
52640 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 52640
Bladder neck treatment
| 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 · 52640
Bladder neck treatment
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
52640 without 51 · national facility
$302.28
Bladder neck treatment
52640-51 · Second procedure: 50%
$151.14
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%).
52640 compared with similar codes
Compare codes
52640 vs 52630 vs 52500 vs 52276: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 52630Prostate resection
- Choose 52640 for contracture scar at the bladder neck; choose 52630 when recurrent or residual prostate tissue after prior resection is treated.
- 52500Bladder neck resection
- 52640 specifically addresses a bladder-neck contracture. 52500 is used for transurethral treatment of bladder-neck obstruction when the contracture-specific target is not documented.
- 52276Urethral stricture treatment
- 52640 treats narrowing at the bladder neck. 52276 is for an internal urethrotomy targeting a urethral stricture.
52640 billing questions
How is 52640 different from 52630?
52640 treats contracture scar at the bladder neck. Use 52630 when the operative target is residual or recurrent prostate tissue after prior prostate resection.
What documentation supports 52640?
Document the bladder-neck contracture, its obstructive findings, and the endoscopic treatment performed. Note relevant prior prostate or bladder-neck surgery when applicable.
Does the 90-day global include postoperative care?
Yes. The global includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used?
No. The CMS bilateral adjustment does not apply to this code; modifier 50 is inappropriate.
Can an assistant or co-surgeon be billed?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons and team surgery are not permitted for this service under the CMS rules provided.
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
Fee sheets
Put 52640 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →