CPT code 52260: Bladder distention2026 Medicare rate & RVUs in Massachusetts
Reports cystoscopic bladder distention for interstitial cystitis when performed under general or spinal anesthesia.
CMS doesn’t publish an office rate for 52260 in Massachusetts.
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 52260 covers
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.
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 52260 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | Unavailable | $197.09 |
| Rest Of Massachusetts | Unavailable | $186.48 |
How the 52260 rate is calculated
Each of 52260’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 · 52260
RVUs × geographic indexes × conversion factor
Work3.81
3.81 RVUs× 1.000 GPCI
Practice expense1.24
1.24 RVUs× 1.000 GPCI
Malpractice0.51
0.51 RVUs× 1.000 GPCI
Adjusted RVUs
5.5600
Conversion factor
$33.4009
Medicare rate
$185.71
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 52260
The CMS indicators that decide how 52260 is paid alongside other services.
CMS payment indicators · 52260
Bladder distention
| 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
52260 without 51 · national facility
$185.71
Bladder distention
52260-51 · Second procedure: 50%
$92.86
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%).
52260 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 52265Urethral fulguration
- Both codes cover cystoscopic bladder distention for interstitial cystitis. Choose 52260 for general or spinal anesthesia and 52265 for local anesthesia.
- 52204Cystoscopic biopsy
- 52204 reports bladder biopsy obtained during cystoscopy. Use 52260 for bladder distention to treat interstitial cystitis, not for tissue sampling alone.
- 52224Bladder lesion treatment
- 52224 is used for cystoscopic treatment of small bladder lesions. 52260 describes bladder distention for interstitial cystitis rather than lesion treatment.
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 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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