Billing code 51792: Urinary reflex studyMedicare rate & RVUs in Ohio
Reports a diagnostic study of reflex pathways involved in urinary control, typically when evaluating suspected neurologic impairment affecting bladder or urethral function.
Medicare pays $229.38 for 51792 in the office in Ohio (Ohio). 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 51792 covers
A urinary reflex study evaluates the reflex response involved in urinary control, rather than simply measuring urine flow or bladder filling pressure. The clinician stimulates a relevant reflex pathway and records the physiologic response to assess neuromuscular function. Urologists and other clinicians evaluating urinary dysfunction may order the test when neurologic involvement is suspected; it is commonly performed in an office urodynamics setting by trained staff, with physician interpretation.
Select this service when the documented test is a urinary reflex study, not a cystometrogram, uroflow measurement, or sphincter electromyography study. The record should identify the reflex testing performed, the clinical indication, and the findings supporting the interpretation. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. The service may be billed globally or split into professional interpretation with modifier 26 and technical equipment and staff with modifier TC. When multiple procedures occur in one session, the highest-valued is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate; assistant-at-surgery payment requires documented medical necessity, 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.
51792 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $229.38 | Unavailable |
How the 51792 rate is calculated
Each of 51792’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 · 51792
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.07Practice expense 6.14Malpractice 0.19
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 51792
The CMS indicators that decide how 51792 is paid alongside other services.
CMS payment indicators · 51792
Urinary reflex study
| 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 | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
51792 without 26 · national office
$247.17
Urinary reflex study
51792-26 · Professional component
$56.11
Pays only the interpretation and report.
51792 compared with similar codes
Compare codes
51792 vs 51784 vs 51785 vs 51726 vs 51741: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 51784Sphincter EMG
- Choose 51784 for non-needle electromyography of anal or urinary sphincter muscle activity. Choose 51792 when the documented service is urinary reflex response testing.
- 51785Sphincter EMG
- 51785 reports needle electromyography of anal or urinary sphincter muscle activity; 51792 reports a urinary reflex study, not needle muscle testing.
- 51726Cystometrogram
- 51726 reports complex cystometry, which measures bladder pressure and filling function. 51792 is selected for reflex response testing.
- 51741Uroflowmetry
- 51741 reports complex uroflowmetry, measuring urine flow during voiding. It is not a study of urinary reflex pathways.
51792 billing questions
How is 51792 different from cystometry?
51792 evaluates a urinary reflex response. Cystometry codes such as 51726 measure bladder pressure during filling and related testing.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the professional interpretation or TC for the technical equipment and staff; without either modifier, the claim represents the global service.
Is modifier 50 appropriate?
No. CMS identifies modifier 50 as inappropriate for this service's descriptor and anatomy.
What same-day care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
How does the multiple procedure rule affect payment?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple procedure reduction.
What documentation supports reporting 51792?
Document the clinical reason for reflex testing, the reflex study performed, and the recorded response and interpretation. The record should distinguish the study from pressure testing, urine-flow measurement, and sphincter EMG.
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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