$746.00
52214 is selected for treatment at its specified anatomic sites. 52224 describes treatment of minor bladder lesion(s), so the documented location and lesion treatment determine the choice.
On this page
CMS RVU26D · Effective 2026-10-01
52214 Cystoscopy treatment Medicare reimbursement rates in Vermont
Reports cystoscopic fulguration or comparable lesion treatment at the trigone, bladder neck, prostatic fossa, urethra, or periurethral glands. Compare 52214 office and facility rates across CMS payment localities in Vermont.
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 52214 in Vermont?
Vermont 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
$714.38
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$144.64
1 of 1 localities have a supported rate.
Payment area: Vermont
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 52214: Cystoscopic fulguration at specified urinary sites
Reports cystoscopic fulguration or comparable lesion treatment at the trigone, bladder neck, prostatic fossa, urethra, or periurethral glands.
A urologist passes a cystoscope to visualize and destroy or treat lesions at the trigone, bladder neck, prostatic fossa, urethra, or periurethral glands. Treatment may use electrosurgical fulguration, cryosurgery, or laser. The procedure may be performed in an office or facility setting, depending on the patient and planned treatment. This code is distinguished by the treated anatomic site; it is not the size-based code for resection of a bladder tumor.
Report the service when the operative or procedure note identifies the treated site and the method used. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for it, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 52214
- 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 RVU3.41 · 16%
- Practice expense (office) RVU17.94 · 82%
- Malpractice RVU0.43 · 2%
14.5K
Medicare services in 2024 · #1273 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.
52214 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
52234 is a size-based code for treatment of a small bladder tumor. Use 52214 for treatment at its specified sites rather than selecting a bladder-tumor size level.
$347.18
52204 reports cystoscopic biopsy. Use it when tissue is sampled; 52214 reports treatment by fulguration or another included destruction method at its specified sites.
Compare 52214 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
Vermont →
Office / nonfacility
$714.38
Facility
$144.64
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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 52214 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
6,112
- Code
- 52214
- Physician work
- 3.41
- Practice expense
- 17.94
- Malpractice
- 0.43
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.41 | × 1.000 | 3.4100 |
| Practice expense | 17.94 | × 0.990 | 17.7606 |
| Malpractice | 0.43 | × 0.506 | 0.2176 |
| Total RVUs | 21.3882 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$714.38
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.41 | 1 |
| Practice expense | 17.94 | 0.99 |
| Malpractice | 0.43 | 0.506 |
(3.41 × 1 + 17.94 × 0.99 + 0.43 × 0.506) × $33.4009 = $714.38
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.41 | 1 |
| Practice expense | 0.71 | 0.99 |
| Malpractice | 0.43 | 0.506 |
(3.41 × 1 + 0.71 × 0.99 + 0.43 × 0.506) × $33.4009 = $144.64
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.
52214 billing questions
How does 52214 differ from 52224?
52214 covers treatment at the specified sites, such as the urethra or bladder neck. 52224 is used for treatment of minor bladder lesion(s); choose by the documented site and procedure.
When is a bladder tumor code a better fit?
For cystoscopic treatment of a bladder tumor, compare the size-based codes such as 52234 and 52235. 52214 is for the named sites in its descriptor, not a tumor-size level.
Can a biopsy be reported with 52214?
The procedure note should distinguish tissue sampling from lesion destruction. If a separate biopsy is performed, review applicable coding edits and documentation before reporting 52204 with 52214.
Can modifier 50 be used for treatment on both sides?
No. CMS identifies bilateral adjustment as inappropriate for 52214, so do not append modifier 50.
How does payment work when another endoscopy is performed in the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together. Same-day preoperative and postoperative care is included in this code's 0-day global period.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for 52214. 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 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.
6,1095200F,,Eval appros surg thxpy epi,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
6,11052010,,Cystoscopy & duct catheter,A,,2.94,7.61,,1.09,,0.38,10.93,4.41,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11152204,,Cystoscopy w/biopsy(s),A,,2.53,7.77,,0.93,,0.34,10.64,3.80,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11252214,,Cystoscopy and treatment,A,,3.41,17.94,,0.71,,0.43,21.78,4.55,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11352224,,Cystoscopy and treatment,A,,3.95,18.32,,0.82,,0.49,22.76,5.26,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11452234,,Cystoscopy and treatment,A,,4.50,1.42,NA,1.42,,0.57,6.49,6.49,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11552235,,Cystoscopy and treatment,A,,5.30,1.64,NA,1.64,,0.68,7.62,7.62,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817