CPT 52214
Global 000 ActiveCystoscopy and treatment
CPT 52214 Billing & Documentation Guide
CPT code 52214 (Cystoscopy and treatment) is classified under Surgery (Urinary/Reproductive) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.41, a non-facility practice expense RVU of 17.94, and a malpractice RVU of 0.43, a total non-facility RVU of 21.78 and facility RVU of 4.55. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $753.88, though rates vary from $636.02 to $998.19 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 52214, 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 52214 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 52214 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 52214
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.41 | 3.41 |
| Practice Expense RVU | 17.94 | 0.71 |
| Malpractice RVU | 0.43 | 0.43 |
| Total RVU | 21.78 | 4.55 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 52214
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 | $834.8 | $153.83 | $780.27 - $998.19 | 29 |
| Florida | $743.07 | $165.65 | $708.33 - $774 | 3 |
| Georgia | $702.9 | $153.88 | $665.51 - $740.29 | 2 |
| Illinois | $720.73 | $164.66 | $683.43 - $755.54 | 4 |
| Michigan | $696.77 | $156.38 | $677.19 - $716.35 | 2 |
| North Carolina | $682.14 | $145.2 | $682.14 - $682.14 | 1 |
| New York | $807.31 | $165.28 | $693.25 - $860.32 | 5 |
| Ohio | $675.46 | $150.03 | $675.46 - $675.46 | 1 |
| Pennsylvania | $717.2 | $153.51 | $677.55 - $756.86 | 2 |
| Texas | $717.79 | $151.21 | $672.52 - $760.82 | 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 52214
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 52214 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 |
| 00912 | 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 |
| 0420U | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 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 52214
What does CPT code 52214 mean? +
CPT code 52214 represents: Cystoscopy and treatment. It's in the Surgery (Urinary/Reproductive) category with a global period of 000.
What is the Medicare reimbursement for CPT 52214? +
The 2026 Medicare national average non-facility payment for CPT 52214 is $753.88. Rates range from $636.02 to $998.19 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 52214? +
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 52214? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team