$671.97
Choose 52265 for fulguration associated with female urethral syndrome. Choose 52214 when fulguration targets the specified sites such as the trigone, bladder neck, prostatic fossa, urethra, or periurethral glands.
On this page
CMS RVU26D · Effective 2026-10-01
52265 Urethral fulguration Medicare reimbursement rates in Idaho
Report cystoscopic fulguration when a urologist treats tissue associated with female urethral syndrome using cautery, laser, or cryosurgery. Compare 52265 office and facility rates across CMS payment localities in Idaho.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 52265 in Idaho?
Idaho has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$319.13
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
Facility setting
$134.15
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Urology procedure
About 52265: Cystoscopic fulguration for female urethral syndrome
Report cystoscopic fulguration when a urologist treats tissue associated with female urethral syndrome using cautery, laser, or cryosurgery.
A urologist passes a cystoscope through the urethra to examine and destroy targeted tissue associated with female urethral syndrome. Fulguration may use cautery, laser, or cryosurgery. The service is distinct from a diagnostic cystoscopy alone and from treatment directed at bladder lesions or other specifically named sites. It is typically performed in an outpatient setting, including an office or a procedure facility.
Report the service when the operative documentation supports the female urethral syndrome indication and identifies the treated tissue and method. The CMS global period is zero days, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies; payment should not be assumed to accrue independently for each procedure. Modifier 50 is inappropriate. Medicare does not pay for an assistant at surgery, and co-surgeons and team surgery are not permitted for this code.
CMS billing rules for 52265
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.87 · 28%
- Practice expense (office) RVU7.05 · 68%
- Malpractice RVU0.42 · 4%
887
Medicare services in 2024 · #3057 by national volume
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.
52265 compared with similar codes
Office rates for Idaho, from the same CMS release.
$702.63
52224 is for cystoscopic fulguration of minor bladder lesion(s). 52265 is tied to female urethral syndrome, not the size-based treatment of bladder lesions.
$328.64
52204 reports cystoscopic biopsy. Fulguration associated with female urethral syndrome is the defining service for 52265; use the code that reflects the documented procedure.
No office rate
52260 describes bladder dilation for interstitial cystitis. It is not the cystoscopic fulguration service for female urethral syndrome reported with 52265.
Compare 52265 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Idaho →
Office / nonfacility
$319.13
Facility
$134.15
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 52265 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
6,119
- Code
- 52265
- Physician work
- 2.87
- Practice expense
- 7.05
- Malpractice
- 0.42
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.87 | × 1.000 | 2.8700 |
| Practice expense | 7.05 | × 0.920 | 6.4860 |
| Malpractice | 0.42 | × 0.473 | 0.1987 |
| Total RVUs | 9.5547 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Idaho$319.13
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.87 | 1 |
| Practice expense | 7.05 | 0.92 |
| Malpractice | 0.42 | 0.473 |
(2.87 × 1 + 7.05 × 0.92 + 0.42 × 0.473) × $33.4009 = $319.13
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.87 | 1 |
| Practice expense | 1.03 | 0.92 |
| Malpractice | 0.42 | 0.473 |
(2.87 × 1 + 1.03 × 0.92 + 0.42 × 0.473) × $33.4009 = $134.15
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
52265 billing questions
How is 52265 distinguished from 52214?
52265 is for cystoscopic fulguration associated with female urethral syndrome. 52214 is used for fulguration of its specified anatomic sites, such as the trigone or bladder neck.
Is diagnostic cystoscopy separately reported with 52265?
The cystoscopic examination used to perform the fulguration is part of the service. The record should show the indication and what tissue was treated, rather than only a diagnostic examination.
Can modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code because the descriptor or anatomy makes modifier 50 unsuitable.
How does CMS price 52265 with another endoscopy?
When related endoscopies are performed together, CMS endoscopy-family pricing applies. Payment is not simply assumed to be independent for each endoscopic service.
What surgical-assistance claims are permitted?
Medicare does not pay an assistant at surgery for 52265. Co-surgeons and team surgery are also 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,11652240,,Cystoscopy and treatment,A,,7.31,2.05,NA,2.05,,0.95,10.31,10.31,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11752250,,Cystoscopy and radiotracer,A,,4.38,1.40,NA,1.40,,0.56,6.34,6.34,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11852260,,Cystoscopy and treatment,A,,3.81,1.24,NA,1.24,,0.51,5.56,5.56,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11952265,,Cystoscopy and treatment,A,,2.87,7.05,,1.03,,0.42,10.34,4.32,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12052270,,Cystoscopy & revise urethra,A,,3.28,8.26,,1.14,,0.43,11.97,4.85,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12152275,,Cystoscopy & revise urethra,A,,4.57,10.39,,1.41,,0.58,15.54,6.56,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12252276,,Cystoscopy and treatment,A,,4.87,1.50,NA,1.50,,0.62,6.99,6.99,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772