CPT 51726
Global 000 ActiveComplex cystometrogram
CPT 51726 Billing & Documentation Guide
CPT code 51726 (Complex cystometrogram) is classified under Surgery (Urinary/Reproductive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.67, a non-facility practice expense RVU of 6.27, and a malpractice RVU of 0.17, a total non-facility RVU of 8.11 and facility RVU of 8.11. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $280.34, though rates vary from $238.6 to $366.95 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 51726, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 51726 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 51726 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 51726
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.67 | 1.67 |
| Practice Expense RVU | 6.27 | 6.27 |
| Malpractice RVU | 0.17 | 0.17 |
| Total RVU | 8.11 | 8.11 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 51726
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $308.66 | $308.66 | $289.3 - $366.95 | 29 |
| Florida | $276.95 | $276.95 | $264.52 - $288.15 | 3 |
| Georgia | $262.45 | $262.45 | $249.35 - $275.54 | 2 |
| Illinois | $269.18 | $269.18 | $255.86 - $281.31 | 4 |
| Michigan | $260.42 | $260.42 | $253.39 - $267.45 | 2 |
| North Carolina | $254.8 | $254.8 | $254.8 - $254.8 | 1 |
| New York | $299.78 | $299.78 | $258.72 - $318.9 | 5 |
| Ohio | $252.71 | $252.71 | $252.71 - $252.71 | 1 |
| Pennsylvania | $267.49 | $267.49 | $253.4 - $281.57 | 2 |
| Texas | $267.54 | $267.54 | $251.63 - $282.49 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 51726
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 51726 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00910 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12002 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 51726
What does CPT code 51726 mean? +
CPT code 51726 represents: Complex cystometrogram. It's in the Surgery (Urinary/Reproductive) category with a global period of 000.
What is the Medicare reimbursement for CPT 51726? +
The 2026 Medicare national average non-facility payment for CPT 51726 is $280.34. Rates range from $238.6 to $366.95 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 51726? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 51726? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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