Billing code 52649: Laser enucleationMedicare rate & RVUs in Florida
Reports complete laser enucleation of prostate tissue to relieve benign prostatic obstruction, with removed tissue retrieved for examination.
CMS doesn’t publish an office rate for 52649 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 52649 covers
A urologist performs this endoscopic operation for obstructive enlargement of the prostate, commonly in a hospital operating room or ambulatory surgery setting. Laser energy separates obstructing prostate tissue from the surrounding surgical capsule; the freed tissue is typically fragmented and removed from the bladder for pathologic examination. The operation is distinct from vaporizing prostate tissue or resecting it in chips.
Select this code when the operative report supports complete laser enucleation, rather than vaporization or resection. Document the indication, laser enucleation technique, extent of tissue removal, and any tissue retrieval. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Report the service once; modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity. Co-surgeons and team surgery 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 52649 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 | $703.31 |
| Miami | Unavailable | $747.58 |
| Rest Of Florida | Unavailable | $676.50 |
How the 52649 rate is calculated
Each of 52649’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 · 52649
RVUs × geographic indexes × conversion factor
Work12.68
12.68 RVUs× 1.000 GPCI
Practice expense5.36
5.36 RVUs× 1.000 GPCI
Malpractice1.63
1.63 RVUs× 1.000 GPCI
Adjusted RVUs
19.6700
Conversion factor
$33.4009
Medicare rate
$657.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 52649
52649 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 52649
Laser enucleation
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 52649
Laser enucleation
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
52649 without 51 · national facility
$657.00
Laser enucleation
52649-51 · Second procedure: 50%
$328.50
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%).
52649 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 52648Laser prostate surgery
- Choose 52649 for laser enucleation with tissue removal; choose 52648 when laser energy vaporizes the obstructing tissue.
- 52601TURP
- 52601 represents transurethral resection of prostate tissue. 52649 is selected when the surgeon performs complete laser enucleation instead.
- 52630Prostate resection
- 52630 addresses transurethral removal of prostate regrowth after prior surgery; 52649 describes complete laser enucleation, not treatment defined by regrowth.
52649 billing questions
How is 52649 distinguished from laser vaporization?
52649 describes enucleating and removing prostate tissue. Use the vaporization code when the operative technique vaporizes tissue rather than freeing and removing it.
Is morcellation separately reported?
No. Fragmenting and retrieving the enucleated tissue is part of the complete enucleation service when performed.
Can modifier 50 be appended?
No. Report the prostate enucleation once; bilateral adjustment is inappropriate for this service.
What documentation supports 52649?
The operative report should identify the laser enucleation technique, the obstructive indication, and the extent of tissue enucleated and retrieved.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and additional procedures are subject to the standard multiple-procedure reduction.
When is assistant-at-surgery payment allowed?
Only when the record documents the medical necessity of the assistant. Co-surgeon and team-surgery payment is 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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