$223.65–$247.98
52000 represents cystourethroscopy without the clot-irrigation and evacuation service. Use 52001 when multiple obstructing clots are actively irrigated and evacuated.
On this page
CMS RVU26D · Effective 2026-10-01
52001 Clot evacuation Medicare reimbursement rates in Massachusetts
Reports cystoscopic irrigation and removal of multiple obstructing bladder clots, typically for gross hematuria causing clot retention or impaired bladder drainage. Compare 52001 office and facility rates across CMS payment localities in Massachusetts.
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 52001 in Massachusetts?
Massachusetts 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
$429.39–$466.91
2 of 2 localities have a supported rate.
Facility setting
$253.88–$267.91
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
About 52001: Cystoscopic evacuation of bladder clots
Reports cystoscopic irrigation and removal of multiple obstructing bladder clots, typically for gross hematuria causing clot retention or impaired bladder drainage.
A urologist passes a cystoscope through the urethra into the bladder, then irrigates and evacuates multiple clots obstructing bladder drainage. The procedure is commonly performed in a hospital or other procedural setting for gross hematuria with clot retention, such as when clots prevent adequate emptying or catheter drainage. The code describes endoscopic clot removal, not simple catheter irrigation alone.
Report the service for the cystoscopic treatment of multiple obstructing clots; document the obstruction, endoscopic irrigation and evacuation, and clinical reason for intervention. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.
CMS billing rules for 52001
- 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 RVU5.30 · 42%
- Practice expense (office) RVU6.58 · 52%
- Malpractice RVU0.68 · 5%
12.7K
Medicare services in 2024 · #1353 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.
52001 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$80.97–$89.59
51700 describes bladder irrigation by instillation. It does not represent cystoscopic evacuation of multiple obstructing clots.
$290.10–$320.25
52005 includes ureteral catheterization during cystourethroscopy. It is not the code for evacuating multiple obstructing bladder clots.
Compare 52001 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
Metropolitan Boston →
Office / nonfacility
$466.91
Facility
$267.91
Rest Of Massachusetts →
Office / nonfacility
$429.39
Facility
$253.88
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52001 billing questions
When is 52001 more appropriate than diagnostic cystoscopy?
Use 52001 when cystoscopy includes irrigation and evacuation of multiple obstructing clots. A diagnostic examination without that clot treatment is a different service.
Can bladder irrigation by catheter be reported instead?
Simple irrigation through a catheter is distinct from cystoscopic evacuation of multiple obstructing clots. Select the service that matches the documented method and work performed.
Should 52001 be reported once for each clot?
No. The code represents the cystoscopic clot-evacuation procedure, not a separate unit for every clot removed.
How are related endoscopies priced when performed together?
CMS endoscopy-family pricing applies when related endoscopies are performed together. Document each distinct procedure performed during the session.
Can modifier 50 or an assistant-at-surgery claim be used?
No. Modifier 50 is inappropriate for this code, and Medicare does not pay an assistant at surgery for it.
Are co-surgeons or team surgery allowed?
CMS does not permit co-surgeons or team surgery for this service.
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.
6,10351992,,Laparo sling operation,A,,14.50,5.47,NA,5.47,,2.38,22.35,22.35,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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