$293.21
Choose 52276 for direct-vision incision of a urethral stricture. Choose 52281 for cystourethroscopic calibration and/or dilation.
On this page
CMS RVU26D · Effective 2026-10-01
52276 Urethral stricture treatment Medicare reimbursement rates in Wisconsin
Reports endoscopic incision of a urethral stricture under direct vision, typically when a urologist treats scar-related narrowing of the urethral lumen. Compare 52276 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 52276 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
$217.04
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 52276: Direct vision internal urethrotomy
Reports endoscopic incision of a urethral stricture under direct vision, typically when a urologist treats scar-related narrowing of the urethral lumen.
A urologist passes a cystourethroscope through the urethra and directly visualizes a scarred, narrowed segment before incising it to open the lumen. This procedure is commonly performed in a hospital outpatient department or ambulatory surgery center for urethral stricture disease; the operative report should identify the stricture and describe the incision performed.
Select 52276 when the surgeon treats the narrowing by incision under direct vision, rather than by dilation alone or a meatotomy for narrowing at the urethral opening. Document the stricture location, endoscopic findings, and technique. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 52276
- 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 RVU4.87 · 70%
- Practice expense (office) RVU1.50 · 21%
- Malpractice RVU0.62 · 9%
6.4K
Medicare services in 2024 · #1713 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.
52276 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$2,565.85
52276 identifies direct-vision internal incision; 52284 represents a distinct mechanical approach to treating urethral narrowing. Base selection on the documented technique.
$378.28
52270 is a urethral meatotomy procedure. Use 52276 when the operative service is incision of a urethral stricture under direct vision.
Compare 52276 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
$217.04
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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 52276 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
6,122
- Code
- 52276
- Physician work
- 4.87
- Practice expense
- 1.50
- Malpractice
- 0.62
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.87 | × 1.000 | 4.8700 |
| Practice expense | 1.50 | × 0.958 | 1.4370 |
| Malpractice | 0.62 | × 0.308 | 0.1910 |
| Total RVUs | 6.4980 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$217.04
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.87 | 1 |
| Practice expense | 1.5 | 0.958 |
| Malpractice | 0.62 | 0.308 |
(4.87 × 1 + 1.5 × 0.958 + 0.62 × 0.308) × $33.4009 = $217.04
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.
52276 billing questions
When is 52276 preferable to 52281?
Use 52276 when the surgeon incises the urethral stricture under direct vision. Code 52281 is for cystourethroscopic calibration and/or dilation of a stricture or stenosis.
How does 52276 differ from 52284?
Both address urethral narrowing, but 52276 describes direct-vision internal incision. Review the operative technique to determine whether the service fits 52284’s distinct mechanical treatment approach.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inapplicable because the descriptor or anatomy makes modifier 50 inappropriate.
What same-day care is included?
The 0-day global period includes preoperative and postoperative care on the procedure date. Related endoscopies performed together are subject to CMS endoscopy-family pricing.
Can an assistant or co-surgeon be paid?
CMS restricts assistant-at-surgery payment for this code. 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.
6,11952265,,Cystoscopy and treatment,A,,2.87,7.05,,1.03,,0.42,10.34,4.32,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12052270,,Cystoscopy & revise urethra,A,,3.28,8.26,,1.14,,0.43,11.97,4.85,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12152275,,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
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,,,,,,