CPT 52000
Global 000 ActiveCystourethroscopy
CPT 52000 Billing & Documentation Guide
CPT code 52000 (Cystourethroscopy) is classified under Surgery (Urinary/Reproductive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.49, a non-facility practice expense RVU of 4.77, and a malpractice RVU of 0.2, a total non-facility RVU of 6.46 and facility RVU of 2.13. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $222.78, though rates vary from $190.07 to $288.57 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 52000, 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 52000 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 52000 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 52000
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.49 | 1.49 |
| Practice Expense RVU | 4.77 | 0.44 |
| Malpractice RVU | 0.2 | 0.2 |
| Total RVU | 6.46 | 2.13 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 52000
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 | $243.7 | $72.56 | $228.81 - $288.57 | 29 |
| Florida | $222.63 | $77.52 | $212.12 - $232.52 | 3 |
| Georgia | $209.83 | $71.86 | $199.85 - $219.81 | 2 |
| Illinois | $216.66 | $76.91 | $205.67 - $225.58 | 4 |
| Michigan | $208.78 | $72.97 | $202.77 - $214.78 | 2 |
| North Carolina | $202.68 | $67.75 | $202.68 - $202.68 | 1 |
| New York | $238.95 | $77.6 | $205.82 - $254.79 | 5 |
| Ohio | $201.96 | $69.92 | $201.96 - $201.96 | 1 |
| Pennsylvania | $213.42 | $71.75 | $202.34 - $224.49 | 2 |
| Texas | $213.1 | $70.71 | $200.96 - $224.35 | 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 52000
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 52000 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 |
| 00916 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 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 |
| 0548T | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 0582T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0596T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0597T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 52000
What does CPT code 52000 mean? +
CPT code 52000 represents: Cystourethroscopy. It's in the Surgery (Urinary/Reproductive) category with a global period of 000.
What is the Medicare reimbursement for CPT 52000? +
The 2026 Medicare national average non-facility payment for CPT 52000 is $222.78. Rates range from $190.07 to $288.57 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 52000? +
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 52000? +
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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