CPT 52275: UrethrotomyMedicare rate & RVUs in Guam
Endoscopic incision of a female urethral narrowing is reported when the urologist performs internal urethrotomy rather than dilation or meatotomy.
Medicare pays $558.44 for 52275 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 52275 covers
A urologist uses a cystoscope to reach and incise scar tissue narrowing the female urethra. The procedure treats a urethral stricture by opening the narrowed segment from within, rather than simply stretching it or cutting the external urethral opening. It is generally performed in an operating room or outpatient procedural setting; the specific setting depends on the patient and the procedure plan.
Report the code for internal urethrotomy in a female patient, supported by documentation of the stricture and the incision performed. Distinguish the service from urethral dilation or meatotomy, which involve different techniques. CMS 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. CMS 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.
52275 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $558.44 | $217.41 |
How the 52275 rate is calculated
Each of 52275’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 · 52275
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.57Practice expense 10.39Malpractice 0.58
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 52275
The CMS indicators that decide how 52275 is paid alongside other services.
CMS payment indicators · 52275
Urethrotomy
| 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
52275 without 51 · national office
$519.05
Urethrotomy
52275-51 · Second procedure: 50%
$259.53
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%).
52275 compared with similar codes
Compare codes
52275 vs 52276 vs 52270 vs 52265: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 52276Urethral stricture treatment
- 52275 applies to internal urethrotomy in a female patient. 52276 identifies direct-vision internal urethrotomy; use the code that matches the documented procedure and applicable descriptor.
- 52270Urethrotomy
- 52270 describes urethral meatotomy in a female patient, an incision at the urethral opening. 52275 is for internal incision of a urethral stricture.
- 52265Urethral fulguration
- 52265 covers female urethral stricture calibration or dilation, with or without meatotomy. Choose 52275 when the surgeon performs internal urethrotomy instead.
52275 billing questions
How does this differ from 52276?
52275 is for internal urethrotomy in a female patient. 52276 identifies direct-vision internal urethrotomy; select based on the procedure performed and the applicable code description.
Is dilation reported instead of this code?
Use a dilation code when the surgeon dilates or calibrates the narrowed urethra rather than incising the stricture internally. The operative note should make the technique clear.
Can urethral meatotomy be reported with this service?
Meatotomy is a distinct procedure involving an incision at the urethral opening. Do not use it as a substitute for documentation of internal incision of a stricture.
What is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care. CMS does not include a multi-day postoperative period for this procedure.
Can an assistant surgeon or co-surgeon be billed?
CMS 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
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