No office rate
Choose 52640 for contracture scar at the bladder neck; choose 52630 when recurrent or residual prostate tissue after prior resection is treated.
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CMS RVU26D · Effective 2026-10-01
52640 Bladder neck treatment Medicare reimbursement rates in Ohio
Endoscopic treatment of scar narrowing at the bladder neck, reported when a contracture obstructs the outlet and requires operative correction. Compare 52640 office and facility rates across CMS payment localities in Ohio.
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 52640 in Ohio?
Ohio has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$291.42
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
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 surgery
About 52640: Transurethral treatment of bladder neck contracture
Endoscopic treatment of scar narrowing at the bladder neck, reported when a contracture obstructs the outlet and requires operative correction.
Code 52640 represents endoscopic operative treatment of a scarred, narrowed bladder neck, generally using a resectoscope to cut or remove contracture tissue and reopen the outlet. Urologists commonly treat this after prior prostate or bladder-neck surgery. The procedure is performed in an operating room, usually under anesthesia, when obstruction is attributable to the bladder-neck scar rather than recurrent prostate tissue or a urethral stricture.
Report 52640 for treatment of the contracture, not simply cystoscopic inspection. The operative report should identify the bladder-neck narrowing, the treatment performed, and relevant prior surgery. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures subject to multiple-procedure payment are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 52640
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- 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 RVU4.67 · 52%
- Practice expense (office) RVU3.79 · 42%
- Malpractice RVU0.59 · 7%
1.4K
Medicare services in 2024 · #2734 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.
52640 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
52640 specifically addresses a bladder-neck contracture. 52500 is used for transurethral treatment of bladder-neck obstruction when the contracture-specific target is not documented.
No office rate
52640 treats narrowing at the bladder neck. 52276 is for an internal urethrotomy targeting a urethral stricture.
Compare 52640 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.
1 of 1 payment localities
Ohio →
Office / nonfacility
Unavailable
Facility
$291.42
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 52640 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
6,167
- Code
- 52640
- Physician work
- 4.67
- Practice expense
- 3.79
- Malpractice
- 0.59
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.67 | × 1.000 | 4.6700 |
| Practice expense | 3.79 | × 0.913 | 3.4603 |
| Malpractice | 0.59 | × 1.008 | 0.5947 |
| Total RVUs | 8.7250 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$291.42
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.67 | 1 |
| Practice expense | 3.79 | 0.913 |
| Malpractice | 0.59 | 1.008 |
(4.67 × 1 + 3.79 × 0.913 + 0.59 × 1.008) × $33.4009 = $291.42
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
52640 billing questions
How is 52640 different from 52630?
52640 treats contracture scar at the bladder neck. Use 52630 when the operative target is residual or recurrent prostate tissue after prior prostate resection.
What documentation supports 52640?
Document the bladder-neck contracture, its obstructive findings, and the endoscopic treatment performed. Note relevant prior prostate or bladder-neck surgery when applicable.
Does the 90-day global include postoperative care?
Yes. The global includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used?
No. The CMS bilateral adjustment does not apply to this code; modifier 50 is inappropriate.
Can an assistant or co-surgeon be billed?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons and team surgery are not permitted for this service under the CMS rules provided.
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.
6,16452597,,Trurl rbtc wtrjt rescj prst8,A,,10.25,4.85,NA,4.85,,1.32,16.42,16.42,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,16552601,,Prostatectomy (turp),A,,9.75,4.74,NA,4.74,,1.26,15.75,15.75,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,16652630,,Remove prostate regrowth,A,,6.39,4.04,NA,4.04,,0.83,11.26,11.26,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,16752640,,Relieve bladder contracture,A,,4.67,3.79,NA,3.79,,0.59,9.05,9.05,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,16852648,,Laser surgery of prostate,A,,9.80,4.75,NA,4.75,,1.27,15.82,15.82,0,090,0.08,0.83,0.09,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,16952649,,Prostate laser enucleation,A,,12.68,5.36,NA,5.36,,1.63,19.67,19.67,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,17052700,,Drainage of prostate abscess,A,,7.30,3.91,NA,3.91,,0.93,12.14,12.14,0,090,0.08,0.83,0.09,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703