Billing code 52214: Cystoscopy treatmentMedicare rate & RVUs in Massachusetts
Reports cystoscopic fulguration or comparable lesion treatment at the trigone, bladder neck, prostatic fossa, urethra, or periurethral glands.
Medicare pays $758.14–$846.81 for 52214 in the office in Massachusetts, from Rest Of Massachusetts to Metropolitan Boston. Which amount applies depends on the service address.
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 9 sections
What 52214 covers
A urologist passes a cystoscope to visualize and destroy or treat lesions at the trigone, bladder neck, prostatic fossa, urethra, or periurethral glands. Treatment may use electrosurgical fulguration, cryosurgery, or laser. The procedure may be performed in an office or facility setting, depending on the patient and planned treatment. This code is distinguished by the treated anatomic site; it is not the size-based code for resection of a bladder tumor.
Report the service when the operative or procedure note identifies the treated site and the method used. The code 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 for this code. Medicare does not pay an assistant at surgery for it, and co-surgeon and team-surgery billing 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.
Where 52214 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | $846.81 | $159.66 |
| Rest Of Massachusetts | $758.14 | $152.14 |
How the 52214 rate is calculated
Each of 52214’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 · 52214
RVUs × geographic indexes × conversion factor
Work3.41
3.41 RVUs× 1.000 GPCI
Practice expense17.94
17.94 RVUs× 1.000 GPCI
Malpractice0.43
0.43 RVUs× 1.000 GPCI
Adjusted RVUs
21.7800
Conversion factor
$33.4009
Medicare rate
$727.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 52214
The CMS indicators that decide how 52214 is paid alongside other services.
CMS payment indicators · 52214
Cystoscopy treatment
| 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
52214 without 51 · national office
$727.47
Cystoscopy treatment
52214-51 · Second procedure: 50%
$363.74
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%).
52214 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 52224Bladder lesion treatment
- 52214 is selected for treatment at its specified anatomic sites. 52224 describes treatment of minor bladder lesion(s), so the documented location and lesion treatment determine the choice.
- 52234Bladder tumor treatment
- 52234 is a size-based code for treatment of a small bladder tumor. Use 52214 for treatment at its specified sites rather than selecting a bladder-tumor size level.
- 52204Cystoscopic biopsy
- 52204 reports cystoscopic biopsy. Use it when tissue is sampled; 52214 reports treatment by fulguration or another included destruction method at its specified sites.
52214 billing questions
How does 52214 differ from 52224?
52214 covers treatment at the specified sites, such as the urethra or bladder neck. 52224 is used for treatment of minor bladder lesion(s); choose by the documented site and procedure.
When is a bladder tumor code a better fit?
For cystoscopic treatment of a bladder tumor, compare the size-based codes such as 52234 and 52235. 52214 is for the named sites in its descriptor, not a tumor-size level.
Can a biopsy be reported with 52214?
The procedure note should distinguish tissue sampling from lesion destruction. If a separate biopsy is performed, review applicable coding edits and documentation before reporting 52204 with 52214.
Can modifier 50 be used for treatment on both sides?
No. CMS identifies bilateral adjustment as inappropriate for 52214, so do not append modifier 50.
How does payment work when another endoscopy is performed in the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together. Same-day preoperative and postoperative care is included in this code's 0-day global period.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for 52214. 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 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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