$205.67–$225.58
52000 describes cystourethroscopy without ureteral catheterization. Choose 52005 when the cystoscope is used to guide a catheter into a ureter.
On this page
CMS RVU26D · Effective 2026-10-01
52005 Ureteral catheterization Medicare reimbursement rates in Illinois
Report cystourethroscopy with ureteral catheterization to access a ureter for drainage, instillation, irrigation, or retrograde evaluation. Compare 52005 office and facility rates across CMS payment localities in Illinois.
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 52005 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
$269.17–$294.62
4 of 4 localities have a supported rate.
Facility setting
$122.18–$132.82
4 of 4 localities have a supported rate.
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.
Where 52005 pays more and less in Illinois
4 payment localities
$269.17 to $294.62
Urology endoscopy
About 52005: Cystourethroscopy with ureteral catheterization
Report cystourethroscopy with ureteral catheterization to access a ureter for drainage, instillation, irrigation, or retrograde evaluation.
A urologist passes a cystoscope through the urethra to inspect the bladder and guide a catheter into a ureter. The catheter may be used for irrigation, instillation, or contrast injection for retrograde evaluation of the ureter and collecting system. This service commonly supports evaluation of suspected obstruction, stones, or narrowing and may be performed in an operating room or another setting equipped for cystoscopy and imaging.
Report the service when the ureteral catheterization is performed; the cystoscopic access is part of the service, not a separate diagnostic cystoscopy. Document the ureter accessed and the catheterization and any irrigation, instillation, or retrograde study performed. Radiologic services are separate from this code. Medicare 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. Do not use modifier 50 for bilateral catheterization. Medicare does not pay an assistant at surgery for this code, and co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 52005
- 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 RVU2.31 · 28%
- Practice expense (office) RVU5.80 · 69%
- Malpractice RVU0.29 · 3%
25.4K
Medicare services in 2024 · #1043 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.
52005 compared with similar codes
Office rates for Illinois, from the same CMS release.
$411.22–$451.18
52007 includes brush biopsy of the ureter and/or renal pelvis with ureteral catheterization; 52005 describes catheterization without that biopsy service.
$413.18–$451.27
52001 is for cystoscopic irrigation and evacuation of multiple bladder clots. It is not the ureteral catheterization service described by 52005.
Compare 52005 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
$294.62
Facility
$132.82
East St. Louis →
Office / nonfacility
$274.89
Facility
$126.78
Rest Of Illinois →
Office / nonfacility
$269.17
Facility
$122.18
Suburban Chicago →
Office / nonfacility
$293.82
Facility
$128.48
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
52005 billing questions
When should 52005 be reported instead of 52000?
Report 52005 when the cystoscopy includes catheterization of a ureter. Use 52000 for cystourethroscopy without ureteral catheterization.
Can 52000 be billed separately with 52005?
The cystourethroscopy used to perform the ureteral catheterization is included in 52005. Do not separately report 52000 for that same cystoscopic access.
How does 52005 differ from 52007?
52007 is the related code when ureteral or renal-pelvis brush biopsy is performed along with ureteral catheterization. Use 52005 when that biopsy service is not performed.
Should modifier 50 be added when both ureters are catheterized?
No. CMS identifies bilateral adjustment as inapplicable to 52005, so modifier 50 is inappropriate.
Is retrograde imaging included in 52005?
The code may include ureteropyelography, but the radiologic service is separate. Report a radiology service only when its requirements are met and the service is documented.
Can an assistant or co-surgeon be reported for 52005?
Medicare does not pay an assistant at surgery for this code. Co-surgeon and team-surgery reporting 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 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.
6,10451999,,Unlisted laps px bladder,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,0,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6,10552000,,Cystourethroscopy,A,,1.49,4.77,,0.44,,0.20,6.46,2.13,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,10652001,,Cysto w/irrg&evac mlt clots,A,,5.30,6.58,,1.59,,0.68,12.56,7.57,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,10752005,,Cysto w/urtrl cathj,A,,2.31,5.80,,0.98,,0.29,8.40,3.58,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,10852007,,Cysto urtrl cathj brush bx,A,,2.94,9.58,,1.09,,0.40,12.92,4.43,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,1095200F,,Eval appros surg thxpy epi,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
6,11052010,,Cystoscopy & duct catheter,A,,2.94,7.61,,1.09,,0.38,10.93,4.41,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00