Billing code 52281: Urethral dilationMedicare rate & RVUs in Oregon
Cystoscopic dilation widens a urethral narrowing, with or without meatotomy, when a urologist treats obstructive symptoms from stricture or stenosis.
Medicare pays $305.89–$331.82 for 52281 in the office in Oregon, from Rest Of Oregon to Portland. 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 52281 covers
A urologist uses a cystoscope to evaluate a narrowed urethral segment and calibrate or widen it with suitable dilators. The procedure may also include a meatotomy when the narrowing involves the urethral opening. It is performed for urethral stricture or stenosis associated with symptoms such as impaired urinary flow, in an office or facility setting depending on the clinical circumstances and resources.
Report this code when the documented treatment is cystoscopic calibration or dilation of a urethral narrowing, whether or not meatotomy is performed. The record should identify the stricture or stenosis, its location when known, the treatment performed, and any meatotomy. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS applies endoscopy-family pricing. Report a single procedure rather than modifier 50; the descriptor and anatomy do not support bilateral reporting. Medicare does not pay an assistant at surgery for this service, 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 52281 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $331.82 | $138.86 |
| Rest Of Oregon | $305.89 | $132.90 |
How the 52281 rate is calculated
Each of 52281’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 · 52281
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.68Practice expense 6.25Malpractice 0.36
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 52281
The CMS indicators that decide how 52281 is paid alongside other services.
CMS payment indicators · 52281
Urethral dilation
| 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
52281 without 51 · national office
$310.29
Urethral dilation
52281-51 · Second procedure: 50%
$155.15
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%).
52281 compared with similar codes
Compare codes
52281 vs 52276 vs 52284 vs 53600 vs 52270: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 52276Urethral stricture treatment
- 52281 represents cystoscopic calibration or dilation, potentially with meatotomy. Choose 52276 when the documented treatment is direct-vision incision of the stricture.
- 52284Urethral dilation
- 52284 describes cystoscopic treatment using a drug-coated balloon. 52281 is the code for calibration or dilation without that specific balloon treatment.
- 53600Urethral dilation
- 53600 describes urethral dilation by passage of a sound or dilator. 52281 includes cystoscopic evaluation and treatment of the narrowing.
- 52270Urethrotomy
- 52270 is for cystoscopic urethral meatotomy. 52281 is for calibration or dilation of a stricture or stenosis, with meatotomy permitted as part of that service.
52281 billing questions
When should 52281 be chosen over direct vision internal urethrotomy?
Use 52281 for cystoscopic calibration or dilation of a urethral narrowing, with or without meatotomy. Direct vision internal urethrotomy uses an incision to treat the stricture and is reported with 52276.
Can meatotomy be included in 52281?
Yes. The service may include meatotomy when performed with the cystoscopic calibration or dilation; document the narrowing and the work performed.
How does CMS price 52281 with another endoscopy?
When related endoscopies are performed together, CMS applies endoscopy-family pricing. The record should support each reported procedure.
Should modifier 50 be appended for a narrowing described on both sides?
No. The descriptor and urethral anatomy do not support bilateral reporting for 52281.
Is an assistant surgeon payable for 52281?
Medicare does not pay an assistant at surgery for this code. Co-surgeon and team-surgery billing are also 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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