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See a sample rate comparisonCPT 52214 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Cystoscopy And Treatment, Cystourethroscopy With Fulguration Including Cryosurgery Or Laser Surgery Of Trigone Bladder Neck Prostatic Fossa Urethra Or Periurethral Glands
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52214 |
| Medicaid Fee Schedule | View Medicaid rates for 52214 |
National average reimbursement for CPT 52214 by major payers:
$919.79
$1,016.69
$1,060.58
$372.24
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CPT 52214
5 of 25 sample ratesHigher to lower in this preview
The Western Pennsylvania Hospital, Forbes Regional Campus
Highmark Health
$9,312.99Published rateSaint Lukes South Pain Management Center LLC
$1,834.00Published rateGsi Asc, LLC
Gsi Asc LLC
$1,011.00Published rateWaco Ambulatory Surgery Center, Lp, Waco Cardiology Cath Lab & Surgery Center
$819.50Published rateDoctors Gi Partnership Ltd, Hf Surgery Center At Babcock
Doctors Gi Partnership Ltd
$525.00Published rate
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See a sample payer proposalCPT 52214 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52214 code is part of the Surgery services used for Surgical Procedures on the Urinary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 52214 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 51960-CPT | High | Enterocystoplasty W Bowel Anastomosis |
| 51980-CPT | Moderate | Drain Bladder Through Skin, Surgical Creation Of An Opening Between The Bladder And The Skin Of The Lower Abdomen For Urine Drainage. |
| 52007-CPT | Moderate | Cystoscopy And Biopsy, Cystourethroscopy With Ureteral Catheterization With Or Without Irrigation Instillation Or Ureteropyelography Exclusive Of Radiologic Service With Brush Biopsy Of Ureter And Or Renal Pelvis |
| 52214-CPT | Moderate | Cystoscopy And Treatment, Cystourethroscopy With Fulguration Including Cryosurgery Or Laser Surgery Of Trigone Bladder Neck Prostatic Fossa Urethra Or Periurethral Glands |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52214. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52214 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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