$370.17
This code is for female urethral meatotomy; 52270 is the male counterpart.
On this page
CMS RVU26D · Effective 2026-10-01
52285 Urethral meatotomy Medicare reimbursement rates in Idaho
Cystourethroscopy with incision of a narrowed female urethral opening, reported when the surgeon treats meatal narrowing rather than performing dilation alone. Compare 52285 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 52285 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
$301.98
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
Facility setting
$161.55
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 52285: Female urethral meatotomy with cystoscopy
Cystourethroscopy with incision of a narrowed female urethral opening, reported when the surgeon treats meatal narrowing rather than performing dilation alone.
A urologist uses a cystoscope to inspect the urethra and bladder while surgically opening a narrowed urethral meatus in a female patient. The procedure addresses meatal stenosis that obstructs urine flow or interferes with catheter passage. It may be performed in an operating room or an appropriately equipped outpatient setting; the operative record should identify the narrowing and document the incision or other treatment performed.
Report this code for the female meatal incision service, not for diagnostic cystoscopy alone or for dilation without meatotomy. Documentation should establish the patient’s anatomy, the site and nature of the narrowing, and the treatment performed. 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. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 52285
- 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 RVU3.51 · 36%
- Practice expense (office) RVU5.76 · 59%
- Malpractice RVU0.49 · 5%
1.3K
Medicare services in 2024 · #2801 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.
52285 compared with similar codes
Office rates for Idaho, from the same CMS release.
$481.08
52275 describes internal urethrotomy, a different incision procedure. Use 52285 when the documented treatment is female urethral meatotomy.
$287.26
52281 covers urethral calibration or dilation. It is not the code for an incision of the female urethral meatus.
Compare 52285 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
$301.98
Facility
$161.55
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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 52285 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
6,128
- Code
- 52285
- Physician work
- 3.51
- Practice expense
- 5.76
- Malpractice
- 0.49
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.51 | × 1.000 | 3.5100 |
| Practice expense | 5.76 | × 0.920 | 5.2992 |
| Malpractice | 0.49 | × 0.473 | 0.2318 |
| Total RVUs | 9.0410 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Idaho$301.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.51 | 1 |
| Practice expense | 5.76 | 0.92 |
| Malpractice | 0.49 | 0.473 |
(3.51 × 1 + 5.76 × 0.92 + 0.49 × 0.473) × $33.4009 = $301.98
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.51 | 1 |
| Practice expense | 1.19 | 0.92 |
| Malpractice | 0.49 | 0.473 |
(3.51 × 1 + 1.19 × 0.92 + 0.49 × 0.473) × $33.4009 = $161.55
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.
52285 billing questions
How does this differ from 52270?
52285 is the female urethral meatotomy service; 52270 is its male counterpart. Select based on the patient’s anatomy and the procedure documented.
Can this be reported for urethral dilation alone?
No. This code describes meatotomy with cystourethroscopy; dilation without the meatotomy is a different service.
Can diagnostic cystoscopy be billed separately?
The cystourethroscopic inspection is part of this operative service. Do not separately report a diagnostic cystoscopy for the same operative examination.
What documentation supports reporting this code?
Document female anatomy, the narrowed meatus, the clinical reason for treatment, and the incision or other meatotomy performed.
Which surgical modifiers are appropriate for multiple surgeons?
CMS does not permit assistant-at-surgery, co-surgeon, or team-surgery payment for this code. Modifier 50 is also inappropriate.
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.
6,12552282,,Cystoscopy implant stent,A,,6.23,1.81,NA,1.81,,0.85,8.89,8.89,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12652283,,Cystoscopy and treatment,A,,3.64,5.83,,1.24,,0.47,9.94,5.35,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12752284,,Cysto rx balo cath urtl strx,A,,3.02,76.91,,0.96,,0.39,80.32,4.37,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12852285,,Cystoscopy and treatment,A,,3.51,5.76,,1.19,,0.49,9.76,5.19,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12952287,,Cystoscopy chemodenervation,A,,3.12,7.34,,0.91,,0.43,10.89,4.46,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13052290,,Cystoscopy and treatment,A,,4.47,1.41,NA,1.41,,0.57,6.45,6.45,0,000,0.00,0.00,0.00,3,2,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13152300,,Cystoscopy and treatment,A,,5.17,1.57,NA,1.57,,0.66,7.40,7.40,0,000,0.00,0.00,0.00,3,2,0,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
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