CPT 52224
Global 000 ActiveCystoscopy and treatment
CPT 52224 Billing & Documentation Guide
CPT code 52224 (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 3.95, a non-facility practice expense RVU of 18.32, and a malpractice RVU of 0.49, a total non-facility RVU of 22.76 and facility RVU of 5.26. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $787.24, though rates vary from $665.99 to $1037.58 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 52224, 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 52224 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 52224 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 52224
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.95 | 3.95 |
| Practice Expense RVU | 18.32 | 0.82 |
| Malpractice RVU | 0.49 | 0.49 |
| Total RVU | 22.76 | 5.26 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 52224
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 | $869.59 | $177.95 | $813.6 - $1037.58 | 29 |
| Florida | $777.74 | $191.28 | $741.51 - $810.32 | 3 |
| Georgia | $735.47 | $177.84 | $697.26 - $773.68 | 2 |
| Illinois | $754.92 | $190.14 | $716.18 - $790.28 | 4 |
| Michigan | $729.55 | $180.69 | $709.08 - $750.02 | 2 |
| North Carolina | $713.3 | $167.95 | $713.3 - $713.3 | 1 |
| New York | $843.08 | $190.99 | $724.75 - $898.32 | 5 |
| Ohio | $707.1 | $173.44 | $707.1 - $707.1 | 1 |
| Pennsylvania | $749.98 | $177.45 | $709.13 - $790.83 | 2 |
| Texas | $750.28 | $174.83 | $703.97 - $794.09 | 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 52224
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 52224 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 52224
What does CPT code 52224 mean? +
CPT code 52224 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 52224? +
The 2026 Medicare national average non-facility payment for CPT 52224 is $787.24. Rates range from $665.99 to $1037.58 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 52224? +
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 52224? +
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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