$723.18
52224 is the smaller bladder-tumor treatment level; 52234 applies when the documented tumor measures 0.5 to 2.0 cm.
On this page
CMS RVU26D · Effective 2026-10-01
52234 Bladder tumor treatment Medicare reimbursement rates in Wisconsin
Report this service for cystoscopic treatment or removal of a bladder tumor measuring 0.5 to 2.0 cm, typically by a urologist. Compare 52234 office and facility rates across CMS payment localities in Wisconsin.
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 52234 in Wisconsin?
Wisconsin 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
$201.61
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 52234: Transurethral treatment of small bladder tumor
Report this service for cystoscopic treatment or removal of a bladder tumor measuring 0.5 to 2.0 cm, typically by a urologist.
A urologist uses a cystoscope to access the bladder and treat or remove a tumor in the 0.5-to-2.0-cm size range. Treatment may involve resection or destruction of the lesion, including with electrocautery, laser, or cryosurgery. The service is commonly performed in an operating room or outpatient procedural setting for a patient with a bladder tumor identified during evaluation or surveillance.
Choose this level according to the documented tumor size; smaller and larger tumor levels are reported with their corresponding codes. The operative report should describe the lesion size and treatment performed. This is a minor procedure with 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. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 52234
- 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 RVU4.50 · 69%
- Practice expense (office) RVU1.42 · 22%
- Malpractice RVU0.57 · 9%
27.4K
Medicare services in 2024 · #1006 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.
52234 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
52235 is the next larger bladder-tumor treatment level. Select between the codes using the tumor size documented in the operative report.
$336.63
52204 reports cystoscopic biopsy, while 52234 reports cystoscopic treatment or removal of a bladder tumor in the 0.5-to-2.0-cm range.
Compare 52234 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$201.61
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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 52234 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
6,114
- Code
- 52234
- Physician work
- 4.50
- Practice expense
- 1.42
- Malpractice
- 0.57
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.50 | × 1.000 | 4.5000 |
| Practice expense | 1.42 | × 0.958 | 1.3604 |
| Malpractice | 0.57 | × 0.308 | 0.1756 |
| Total RVUs | 6.0359 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$201.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.5 | 1 |
| Practice expense | 1.42 | 0.958 |
| Malpractice | 0.57 | 0.308 |
(4.5 × 1 + 1.42 × 0.958 + 0.57 × 0.308) × $33.4009 = $201.61
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.
52234 billing questions
How is 52234 distinguished from 52224 or 52235?
52234 is for a bladder tumor measuring 0.5 to 2.0 cm. Use the neighboring tumor-treatment level when the documented size falls into that code’s size category.
When would 52204 be considered instead?
52204 describes cystoscopy with biopsy. Code 52234 represents cystoscopic treatment or removal of a bladder tumor in its size range; submitting tissue for pathology during treatment does not by itself establish a separate biopsy service.
Is modifier 50 appropriate for tumors on both sides of the bladder?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
Are same-day preoperative and postoperative visits included?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be paid for this procedure?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
What happens when related endoscopies are performed during the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together. Review the other endoscopic services against that family pricing rule.
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.
6,11152204,,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
6,11652240,,Cystoscopy and treatment,A,,7.31,2.05,NA,2.05,,0.95,10.31,10.31,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,11752250,,Cystoscopy and radiotracer,A,,4.38,1.40,NA,1.40,,0.56,6.34,6.34,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,