Billing code 52235: Bladder tumor resectionMedicare rate & RVUs in Guam
Reports endoscopic removal or destruction of a medium bladder tumor, sized 2.0 to 5.0 cm, during cystoscopic treatment.
CMS doesn’t publish an office rate for 52235 in Guam.
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 52235 covers
A urologist uses a cystoscope and endoscopic instruments to remove or destroy a bladder tumor measuring 2.0 to 5.0 cm. The treatment may involve resection, electrosurgical fulguration, laser, or cryosurgical techniques. It is commonly performed in an operating room, often as transurethral bladder tumor resection, with the tumor tissue submitted for pathology when removed.
Choose this level from the documented tumor size and operative findings; record the measured lesion and the treatment performed. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; 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.
52235 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $252.46 |
How the 52235 rate is calculated
Each of 52235’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 · 52235
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.30Practice expense 1.64Malpractice 0.68
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 52235
The CMS indicators that decide how 52235 is paid alongside other services.
CMS payment indicators · 52235
Bladder tumor resection
| 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
52235 without 51 · national facility
$254.51
Bladder tumor resection
52235-51 · Second procedure: 50%
$127.26
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%).
52235 compared with similar codes
Compare codes
52235 vs 52224 vs 52234 vs 52240 vs 52204: national Medicare rates
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How to choose
- 52224Bladder lesion treatment
- 52224 is for a smaller bladder lesion category. 52235 is selected for a tumor measuring 2.0 to 5.0 cm.
- 52234Bladder tumor treatment
- 52234 represents a smaller bladder tumor size category; 52235 covers tumors measuring 2.0 to 5.0 cm.
- 52240Bladder tumor treatment
- 52240 is the larger-tumor level. Use 52235 for a documented tumor measuring 2.0 to 5.0 cm.
- 52204Cystoscopic biopsy
- 52204 is for cystoscopic biopsy. 52235 is for endoscopic treatment of a medium bladder tumor by removal or destruction.
52235 billing questions
How is 52235 distinguished from 52234 or 52240?
52235 is for a bladder tumor measuring 2.0 to 5.0 cm. Use the neighboring size-level code when the documented tumor falls into that code’s size category.
When would 52204 be used instead?
52204 describes cystoscopic bladder biopsy. It is the relevant choice when tissue is sampled for diagnosis rather than a medium tumor being resected or destroyed.
Can modifier 50 be used for tumors on both sides of the bladder?
No. Bilateral adjustment does not apply, and the descriptor or anatomy makes modifier 50 inappropriate.
What happens when related endoscopies are performed in the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together, affecting payment for the combined services.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery 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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