$320.96
Both codes cover cystoscopic bladder distention for interstitial cystitis. Choose 52260 for general or spinal anesthesia and 52265 for local anesthesia.
On this page
CMS RVU26D · Effective 2026-10-01
52260 Bladder distention Medicare reimbursement rates in Indiana
Reports cystoscopic bladder distention for interstitial cystitis when performed under general or spinal anesthesia. Compare 52260 office and facility rates across CMS payment localities in Indiana.
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 52260 in Indiana?
Indiana 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
No supported rate
Facility setting
$173.93
1 of 1 localities have a supported rate.
Payment area: Indiana
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
About 52260: Bladder distention for interstitial cystitis
Reports cystoscopic bladder distention for interstitial cystitis when performed under general or spinal anesthesia.
A urologist passes a cystoscope into the bladder and distends the bladder with fluid as treatment for interstitial cystitis. This code is for the procedure performed under general or spinal anesthesia, commonly in an operating room or outpatient surgical setting. The anesthesia type distinguishes it from the corresponding local-anesthesia service.
The operative note should support the interstitial cystitis indication, cystoscopic bladder distention, and anesthesia used. The procedure has 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 bladder procedure. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 52260
- 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 RVU3.81 · 69%
- Practice expense (office) RVU1.24 · 22%
- Malpractice RVU0.51 · 9%
4.6K
Medicare services in 2024 · #1941 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.
52260 compared with similar codes
Office rates for Indiana, from the same CMS release.
$330.60
52204 reports bladder biopsy obtained during cystoscopy. Use 52260 for bladder distention to treat interstitial cystitis, not for tissue sampling alone.
$707.12
52224 is used for cystoscopic treatment of small bladder lesions. 52260 describes bladder distention for interstitial cystitis rather than lesion treatment.
Compare 52260 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
Indiana →
Office / nonfacility
Unavailable
Facility
$173.93
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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 52260 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
6,118
- Code
- 52260
- Physician work
- 3.81
- Practice expense
- 1.24
- Malpractice
- 0.51
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.81 | × 1.000 | 3.8100 |
| Practice expense | 1.24 | × 0.927 | 1.1495 |
| Malpractice | 0.51 | × 0.486 | 0.2479 |
| Total RVUs | 5.2073 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$173.93
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.81 | 1 |
| Practice expense | 1.24 | 0.927 |
| Malpractice | 0.51 | 0.486 |
(3.81 × 1 + 1.24 × 0.927 + 0.51 × 0.486) × $33.4009 = $173.93
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.
52260 billing questions
How is 52260 distinguished from 52265?
Both describe cystoscopic bladder distention for interstitial cystitis. Report 52260 when performed under general or spinal anesthesia; 52265 is the local-anesthesia counterpart.
What documentation supports 52260?
Document interstitial cystitis as the indication, the cystoscopic bladder distention performed, and the use of general or spinal anesthesia.
Can modifier 50 be appended?
No. The bladder procedure is not bilateral, and modifier 50 is inappropriate.
How are related endoscopies handled when performed together?
CMS endoscopy family pricing applies when related endoscopies are performed together. The same-day preoperative and postoperative care is included in the 0-day global period.
Can an assistant or co-surgeon be paid for 52260?
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 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.
6,11552235,,Cystoscopy and treatment,A,,5.30,1.64,NA,1.64,,0.68,7.62,7.62,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11652240,,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
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915