Billing code 52010: CystoscopyMedicare rate & RVUs in Missouri
Report this cystoscopic procedure when a urologist catheterizes an ejaculatory duct, commonly during evaluation or treatment of suspected duct obstruction.
Medicare pays $329.66–$352.90 for 52010 in the office in Missouri, from Rest Of Missouri to Metropolitan St. Louis. 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 52010 covers
A urologist passes a cystoscope through the urethra to the prostate and catheterizes an ejaculatory duct. Irrigation, instillation, or ductography may accompany the catheterization. The service is associated with evaluation or treatment of suspected ejaculatory duct obstruction, including infertility workups. It is typically performed in an operating room or procedure suite.
Report 52010 when the documented service includes ejaculatory duct catheterization; inspection of the bladder or urethra alone is not enough. The note should identify the clinical indication and document the duct catheterization and any irrigation, instillation, or ductography performed. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate for this service. 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.
Where 52010 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$329.66 to $352.90
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City | $349.27 | $144.79 |
| Metropolitan St. Louis | $352.90 | $145.58 |
| Rest Of Missouri | $329.66 | $141.94 |
How the 52010 rate is calculated
Each of 52010’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 · 52010
RVUs × geographic indexes × conversion factor
Work2.94
2.94 RVUs× 1.000 GPCI
Practice expense7.61
7.61 RVUs× 1.000 GPCI
Malpractice0.38
0.38 RVUs× 1.000 GPCI
Adjusted RVUs
10.9300
Conversion factor
$33.4009
Medicare rate
$365.07
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 52010
The CMS indicators that decide how 52010 is paid alongside other services.
CMS payment indicators · 52010
Cystoscopy
| 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
52010 without 51 · national office
$365.07
Cystoscopy
52010-51 · Second procedure: 50%
$182.54
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%).
52010 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 52000Cystoscopy
- Choose 52010 when an ejaculatory duct is catheterized. A cystoscopic examination without that catheterization is represented by 52000.
- 52005Ureteral catheterization
- 52005 is for ureteral catheterization. 52010 is for catheterization of an ejaculatory duct.
- 52007Ureteral biopsy
- 52007 involves ureteral catheterization with brush biopsy; it is not the code for ejaculatory duct catheterization.
52010 billing questions
How does 52010 differ from a diagnostic cystoscopy?
52010 requires catheterization of an ejaculatory duct. Use a diagnostic cystoscopy code when the service is limited to cystoscopic inspection.
Can the diagnostic cystoscopy be billed separately with 52010?
Do not separately report the cystoscopic access and inspection that are part of the duct catheterization service.
Is modifier 50 appropriate?
No. The CMS bilateral adjustment does not apply to 52010, and modifier 50 is inappropriate.
What documentation supports 52010?
Document the indication and the ejaculatory duct catheterization. Also note any irrigation, instillation, or ductography performed.
How is 52010 priced with another endoscopy?
When related endoscopies are performed together, CMS endoscopy family pricing applies.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 52010. 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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