No office rate
52281 represents cystoscopic calibration or dilation, potentially with meatotomy. Choose 52276 when the documented treatment is direct-vision incision of the stricture.
On this page
CMS RVU26D · Effective 2026-10-01
52281 Urethral dilation Medicare reimbursement rates in Vermont
Cystoscopic dilation widens a urethral narrowing, with or without meatotomy, when a urologist treats obstructive symptoms from stricture or stenosis. Compare 52281 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 52281 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
$302.27
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$130.32
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 procedure
About 52281: Cystoscopic urethral stricture dilation
Cystoscopic dilation widens a urethral narrowing, with or without meatotomy, when a urologist treats obstructive symptoms from stricture or stenosis.
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.
CMS billing rules for 52281
- 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 RVU2.68 · 29%
- Practice expense (office) RVU6.25 · 67%
- Malpractice RVU0.36 · 4%
47.9K
Medicare services in 2024 · #798 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.
52281 compared with similar codes
Office rates for Vermont, from the same CMS release.
$2,650.64
52284 describes cystoscopic treatment using a drug-coated balloon. 52281 is the code for calibration or dilation without that specific balloon treatment.
$88.24
53600 describes urethral dilation by passage of a sound or dilator. 52281 includes cystoscopic evaluation and treatment of the narrowing.
$389.95
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.
Compare 52281 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
$302.27
Facility
$130.32
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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 52281 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
6,124
- Code
- 52281
- Physician work
- 2.68
- Practice expense
- 6.25
- Malpractice
- 0.36
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.68 | × 1.000 | 2.6800 |
| Practice expense | 6.25 | × 0.990 | 6.1875 |
| Malpractice | 0.36 | × 0.506 | 0.1822 |
| Total RVUs | 9.0497 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$302.27
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.68 | 1 |
| Practice expense | 6.25 | 0.99 |
| Malpractice | 0.36 | 0.506 |
(2.68 × 1 + 6.25 × 0.99 + 0.36 × 0.506) × $33.4009 = $302.27
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.68 | 1 |
| Practice expense | 1.05 | 0.99 |
| Malpractice | 0.36 | 0.506 |
(2.68 × 1 + 1.05 × 0.99 + 0.36 × 0.506) × $33.4009 = $130.32
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.
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 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.
6,12152275,,Cystoscopy & revise urethra,A,,4.57,10.39,,1.41,,0.58,15.54,6.56,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12252276,,Cystoscopy and treatment,A,,4.87,1.50,NA,1.50,,0.62,6.99,6.99,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12352277,,Cystoscopy and treatment,A,,6.01,1.74,NA,1.74,,0.79,8.54,8.54,0,000,0.00,0.00,0.00,3,0,0,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12452281,,Cystoscopy and treatment,A,,2.68,6.25,,1.05,,0.36,9.29,4.09,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12552282,,Cystoscopy implant stent,A,,6.23,1.81,NA,1.81,,0.85,8.89,8.89,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12652283,,Cystoscopy and treatment,A,,3.64,5.83,,1.24,,0.47,9.94,5.35,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12752284,,Cysto rx balo cath urtl strx,A,,3.02,76.91,,0.96,,0.39,80.32,4.37,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
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