CPT 52310
Global 000 ActiveCystoscopy and treatment
CPT 52310 Billing & Documentation Guide
CPT code 52310 (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 2.74, a non-facility practice expense RVU of 5.84, and a malpractice RVU of 0.36, a total non-facility RVU of 8.94 and facility RVU of 4.03. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $307.25, though rates vary from $265.27 to $389.31 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 52310, 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 52310 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 52310 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 52310
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.74 | 2.74 |
| Practice Expense RVU | 5.84 | 0.93 |
| Malpractice RVU | 0.36 | 0.36 |
| Total RVU | 8.94 | 4.03 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 52310
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 | $332.13 | $138.07 | $313.31 - $389.31 | 29 |
| Florida | $310.64 | $146.09 | $296.07 - $324.99 | 3 |
| Georgia | $292.14 | $135.68 | $279.85 - $304.42 | 2 |
| Illinois | $303.29 | $144.83 | $288.4 - $315.79 | 4 |
| Michigan | $291.61 | $137.61 | $283.18 - $300.03 | 2 |
| North Carolina | $281.19 | $128.18 | $281.19 - $281.19 | 1 |
| New York | $329.82 | $146.86 | $285.28 - $351.63 | 5 |
| Ohio | $281.73 | $132 | $281.73 - $281.73 | 1 |
| Pennsylvania | $296.26 | $135.63 | $281.95 - $310.57 | 2 |
| Texas | $295.23 | $133.77 | $280.19 - $308.73 | 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 52310
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 52310 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 |
| 00918 | 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 |
| 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 |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 52310
What does CPT code 52310 mean? +
CPT code 52310 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 52310? +
The 2026 Medicare national average non-facility payment for CPT 52310 is $307.25. Rates range from $265.27 to $389.31 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 52310? +
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 52310? +
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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