No office rate
52400 treats congenital posterior urethral valves. Choose 52402 when the endoscopic target is the ejaculatory ducts.
On this page
CMS RVU26D · Effective 2026-10-01
52402 Ejaculatory duct procedure Medicare reimbursement rates in Maine
A urologist uses a cystoscope to incise or resect ejaculatory ducts, typically to treat obstruction associated with male infertility. Compare 52402 office and facility rates across CMS payment localities in Maine.
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 52402 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$219.60–$222.45
2 of 2 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.
Urology procedure
About 52402: Transurethral ejaculatory duct incision or resection
A urologist uses a cystoscope to incise or resect ejaculatory ducts, typically to treat obstruction associated with male infertility.
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.
CMS billing rules for 52402
- 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 RVU5.14 · 74%
- Practice expense (office) RVU1.12 · 16%
- Malpractice RVU0.65 · 9%
14
Medicare services in 2024 · #6110 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.
52402 compared with similar codes
Office rates for Maine, from the same CMS release.
$200.50–$211.87
52000 is diagnostic cystourethroscopy. In 52402, cystourethroscopy is used to perform a therapeutic incision or resection of the ejaculatory ducts.
No office rate
52450 is a transurethral incision of the prostate. It is not the code for incision or resection of the ejaculatory ducts.
No office rate
52601 describes transurethral resection of prostate tissue. Use 52402 when the operative target is the ejaculatory ducts, not the prostate.
Compare 52402 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$219.60
Southern Maine →
Office / nonfacility
Unavailable
Facility
$222.45
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.
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 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.
6,15452355,,Cystouretero w/excise tumor,A,,8.78,2.36,NA,2.36,,1.13,12.27,12.27,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52351,33.4009,09,0,99,0.00,0.00,0.00
6,15552356,,Cysto/uretero w/lithotripsy,A,,7.80,2.11,NA,2.11,,1.02,10.93,10.93,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52351,33.4009,09,0,99,0.00,0.00,0.00
6,15652400,,Cysto cgen post urtl valves,A,,8.47,3.26,NA,3.26,,1.09,12.82,12.82,0,090,0.08,0.83,0.09,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,15752402,,Cysto trurl rescj ejacul dux,A,,5.14,1.12,NA,1.12,,0.65,6.91,6.91,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,15852441,,Cysto insj trnsprstc 1 implt,A,,3.90,32.90,,1.13,,0.48,37.28,5.51,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,15952442,,Cysto ins trnsprstc implt ea,A,,0.98,24.77,,0.21,,0.13,25.88,1.32,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,16052443,,Cysto 1st trurl prst8 comis,A,,3.62,172.69,,1.08,,0.46,176.77,5.16,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00