CPT code 52402: Ejaculatory duct procedure2026 Medicare rate & RVUs in Iowa
A urologist uses a cystoscope to incise or resect ejaculatory ducts, typically to treat obstruction associated with male infertility.
CMS doesn’t publish an office rate for 52402 in Iowa.
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 8 sections
What 52402 covers
A urologist performs this endoscopic procedure by passing instruments through the urethra to reach and open or resect the ejaculatory ducts. It is generally used when obstruction of these ducts is linked to impaired semen flow or male infertility. The service is typically performed in a facility setting, such as a hospital or ambulatory surgery center, with the patient under anesthesia.
Report 52402 when the documented work targets the ejaculatory ducts, rather than the prostate or congenital posterior urethral valves. The operative note should identify the indication, endoscopic findings, and the incision or resection 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 code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery 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.
52402 in Iowa
| Payment locality | Office | Facility |
|---|---|---|
| Iowa | Unavailable | $214.53 |
How the 52402 rate is calculated
Each of 52402’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 · 52402
RVUs × geographic indexes × conversion factor
Work5.14
5.14 RVUs× 1.000 GPCI
Practice expense1.12
1.12 RVUs× 1.000 GPCI
Malpractice0.65
0.65 RVUs× 1.000 GPCI
Adjusted RVUs
6.9100
Conversion factor
$33.4009
Medicare rate
$230.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 52402
The CMS indicators that decide how 52402 is paid alongside other services.
CMS payment indicators · 52402
Ejaculatory duct procedure
| 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
52402 without 51 · national facility
$230.80
Ejaculatory duct procedure
52402-51 · Second procedure: 50%
$115.40
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%).
52402 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 52400Valve incision
- 52400 treats congenital posterior urethral valves. Choose 52402 when the endoscopic target is the ejaculatory ducts.
- 52000Cystoscopy
- 52000 is diagnostic cystourethroscopy. In 52402, cystourethroscopy is used to perform a therapeutic incision or resection of the ejaculatory ducts.
- 52450Prostate incision
- 52450 is a transurethral incision of the prostate. It is not the code for incision or resection of the ejaculatory ducts.
- 52601TURP
- 52601 describes transurethral resection of prostate tissue. Use 52402 when the operative target is the ejaculatory ducts, not the prostate.
52402 billing questions
How is 52402 different from 52400?
52402 treats the ejaculatory ducts. Code 52400 is for endoscopic treatment of congenital posterior urethral valves.
Can diagnostic cystoscopy be reported separately?
Cystourethroscopy is part of the described procedure. The diagnostic look used to perform the duct incision or resection is not a separate service.
Should modifier 50 be appended for bilateral duct work?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
What global period applies?
The global period is 0 days. Same-day preoperative and postoperative care is included.
Can an assistant surgeon or co-surgeon be paid?
Medicare does not pay an assistant at surgery for 52402. Co-surgeons and team surgery are also not permitted.
What if another related endoscopy is performed in the same session?
CMS endoscopy family pricing applies when related endoscopies are performed together. Document the procedures performed and their distinct targets.
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
Show the CMS file lines behind this rate
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