No office rate
This code treats congenital posterior urethral obstruction; 52300 is for cystoscopic incision of a ureterocele.
On this page
CMS RVU26D · Effective 2026-10-01
52305 Cystourethroscopy Medicare reimbursement rates in Rhode Island
Cystourethroscopic treatment of congenital posterior urethral valves or an obstructive posterior urethral membrane, typically performed to relieve urinary outflow obstruction. Compare 52305 office and facility rates across CMS payment localities in Rhode Island.
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 52305 in Rhode Island?
Rhode Island 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
$247.38
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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
About 52305: Congenital posterior urethral valve treatment
Cystourethroscopic treatment of congenital posterior urethral valves or an obstructive posterior urethral membrane, typically performed to relieve urinary outflow obstruction.
A urologist treats congenital posterior urethral valves or an obstructive posterior urethral membrane by working through a cystoscope passed into the urethra. The endoscopic intervention opens or removes the obstructing tissue to improve urine flow. This procedure is most often encountered in pediatric urology, including treatment of a child with urinary outflow obstruction identified during evaluation of the lower urinary tract. The operative report should identify the congenital obstruction and describe the treatment performed.
Report this code for treatment of the congenital urethral obstruction, not for incision of a ureterocele or removal of a bladder or urethral foreign body. The note should support the specific diagnosis, endoscopic approach, and intervention. CMS assigns 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 descriptor or anatomy. CMS payment rules also restrict assistant-at-surgery payment and do not permit co-surgeons or team surgery.
CMS billing rules for 52305
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- 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 RVU5.17 · 71%
- Practice expense (office) RVU1.50 · 20%
- Malpractice RVU0.66 · 9%
164
Medicare services in 2024 · #4495 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.
52305 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
This code addresses congenital posterior urethral valves or membrane; 52301 is associated with ureterocele treatment.
$305.48
Use 52310 for simple cystoscopic removal of a foreign body, calculus, or ureteral stent from the bladder or urethra, not congenital outlet obstruction.
$467.17
52315 covers complex cystoscopic removal of a foreign body, calculus, or ureteral stent; it is not treatment of congenital posterior urethral obstruction.
Compare 52305 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$247.38
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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 52305 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
6,133
- Code
- 52305
- Physician work
- 5.17
- Practice expense
- 1.50
- Malpractice
- 0.66
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.17 | × 1.019 | 5.2682 |
| Practice expense | 1.50 | × 1.033 | 1.5495 |
| Malpractice | 0.66 | × 0.892 | 0.5887 |
| Total RVUs | 7.4064 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$247.38
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.17 | 1.019 |
| Practice expense | 1.5 | 1.033 |
| Malpractice | 0.66 | 0.892 |
(5.17 × 1.019 + 1.5 × 1.033 + 0.66 × 0.892) × $33.4009 = $247.38
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.
52305 billing questions
When is this code appropriate instead of 52300 or 52301?
Use this code for endoscopic treatment of congenital posterior urethral valves or an obstructive posterior urethral membrane. Codes 52300 and 52301 concern ureterocele treatment.
Can diagnostic cystoscopy be reported separately?
Cystoscopic access and visualization are part of the operative service. The documentation should describe the congenital obstruction and the treatment performed, rather than treating the diagnostic inspection as a separate service.
Does modifier 50 apply?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor or anatomy.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's global period.
Can an assistant, co-surgeon, or surgical team be paid?
CMS lists a statutory restriction on assistant-at-surgery payment for this code and does not permit co-surgeons or team surgery.
What happens when another related endoscopy is performed during the same session?
CMS endoscopy family pricing applies when related endoscopies are performed together. The operative documentation should support each service reported.
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.
6,13052290,,Cystoscopy and treatment,A,,4.47,1.41,NA,1.41,,0.57,6.45,6.45,0,000,0.00,0.00,0.00,3,2,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13152300,,Cystoscopy and treatment,A,,5.17,1.57,NA,1.57,,0.66,7.40,7.40,0,000,0.00,0.00,0.00,3,2,0,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13252301,,Cystoscopy and treatment,A,,5.36,1.60,NA,1.60,,0.68,7.64,7.64,0,000,0.00,0.00,0.00,3,2,0,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13352305,,Cystoscopy and treatment,A,,5.17,1.50,NA,1.50,,0.66,7.33,7.33,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13452310,,Cystoscopy and treatment,A,,2.74,5.84,,0.93,,0.36,8.94,4.03,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13552315,,Cystoscopy and treatment,A,,5.07,7.96,,1.52,,0.67,13.70,7.26,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13652317,,Remove bladder stone,A,,6.54,18.61,,1.72,,0.85,26.00,9.11,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537