$409.10–$470.76
Choose 52001 when multiple obstructing clots are irrigated and evacuated through the scope. A diagnostic examination with irrigation solely for visualization remains 52000.
On this page
CMS RVU26D · Effective 2026-10-01
52000 Cystoscopy Medicare reimbursement rates in Virginia
Report diagnostic cystourethroscopy to inspect the urethra and bladder when no more extensive cystourethroscopic procedure includes the examination during the same session. Compare 52000 office and facility rates across CMS payment localities in Virginia.
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 52000 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$211.10–$247.57
2 of 2 localities have a supported rate.
Facility setting
$68.93–$77.20
2 of 2 localities have a supported rate.
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 52000: Diagnostic cystourethroscopy of bladder and urethra
Report diagnostic cystourethroscopy to inspect the urethra and bladder when no more extensive cystourethroscopic procedure includes the examination during the same session.
The clinician passes a flexible or rigid cystoscope through the urethra to inspect the urethral lining, bladder neck, bladder walls, and ureteral orifices. Urologists perform the examination most often, sometimes in an office using topical anesthetic gel and a flexible scope. It may also be performed in a hospital or ambulatory surgery center. Common reasons include hematuria, bladder cancer surveillance, recurrent urinary tract infections, voiding symptoms, and suspected urethral stricture.
Report 52000 for a diagnostic examination when a more extensive cystourethroscopy does not include it during the same session. A biopsy, ureteral catheterization, or clot evacuation performed through the scope calls for the applicable procedure code instead. Document the indication, structures examined, and findings. Its 0-day global period includes routine same-day preoperative and postoperative care; a significant, separately identifiable E/M service may be reported with modifier 25. When other procedures are separately reportable in the same session, the standard multiple-procedure rule pays the highest-valued procedure in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted. Office practice expense is higher than facility practice expense.
CMS billing rules for 52000
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU1.49 · 23%
- Practice expense (office) RVU4.77 · 74%
- Malpractice RVU0.20 · 3%
826.9K
Medicare services in 2024 · #164 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.
52000 compared with similar codes
Office rates for Virginia, from the same CMS release.
$274.43–$320.31
If a catheter is passed into a ureter, such as for retrograde pyelography or washings, report 52005 rather than 52000.
$347.63–$407.43
When a bladder or urethral biopsy is the additional procedure performed through the scope, report 52204 rather than 52000. If another treatment is also performed, select the code describing that service.
$291.75–$339.63
When a ureteral stent is removed through a cystoscope from the bladder or urethra by a simple method, report 52310 rather than diagnostic 52000.
Compare 52000 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$247.57
Facility
$77.20
Virginia →
Office / nonfacility
$211.10
Facility
$68.93
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52000 billing questions
Can this code be billed with a cystoscopic bladder biopsy in the same session?
No. When the biopsy includes the diagnostic examination, report the applicable biopsy code rather than 52000.
Is an E/M visit separately billable on the day of an office cystoscopy?
Yes, if the clinician performs a significant, separately identifiable E/M service beyond routine same-day procedure care. The E/M service may concern the same condition; append modifier 25 to the E/M code.
Should modifier 50 be appended because both ureteral orifices are viewed?
No. Viewing both orifices is part of the examination, and the bilateral adjustment is inappropriate for 52000.
Does it matter whether a flexible or rigid cystoscope is used?
The code is the same for either scope type and for male or female patients. The site of service affects practice expense payment, not code selection.
What if the clinician also catheterizes a ureter for retrograde pyelography?
Report 52005 rather than 52000 for cystourethroscopy with ureteral catheterization. The diagnostic examination is included.
What documentation supports this code?
Record the indication, scope type, structures examined, and findings in the urethra and bladder. Document any additional procedure, since it may determine a different code.
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.
6,10251990,,Laparo urethral suspension,A,,13.03,5.35,NA,5.35,,1.71,20.09,20.09,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,10351992,,Laparo sling operation,A,,14.50,5.47,NA,5.47,,2.38,22.35,22.35,0,090,0.08,0.83,0.09,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,10451999,,Unlisted laps px bladder,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,0,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6,10552000,,Cystourethroscopy,A,,1.49,4.77,,0.44,,0.20,6.46,2.13,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6,10652001,,Cysto w/irrg&evac mlt clots,A,,5.30,6.58,,1.59,,0.68,12.56,7.57,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,10752005,,Cysto w/urtrl cathj,A,,2.31,5.80,,0.98,,0.29,8.40,3.58,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,10852007,,Cysto urtrl cathj brush bx,A,,2.94,9.58,,1.09,,0.40,12.92,4.43,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00