CPT 52224 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Urinary System |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| CMS | $718.09 Physician Fee Schedule |
National average reimbursement for CPT 52224 by major payers:
$968.83
$1,064.06
$1,152.31
$1,288.61
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 52224 | ||||||
United | 52224 | $1871.00 | 1184978637 - INLAND VALLEY SURGERY CENTER, LLC | 263900973 - (CA) INLAND VALLEY SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $748.00 | 1588802987 - NATIONAL PARK ENDOSCOPY CENTER, LLC, SOUTH CENTRAL ENDOSCOPY | 260359982 - (AR) NATIONAL PARK ENDOSCOPY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $1362.00 | 1679544290 - KEYSTONE SURGERY CENTER, LTD | 43712391 - (PA) KEYSTONE SURGERY CENTER LTD | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $712.76 | 1740442615 - CENTER FOR ADVANCED REPRODUCTIVE SERVICES, PC, AMBULATORY SURGICAL CENTER AT REPRODUCTIVE SERVICES | 61522659 - (CT) CENTER FOR ADVANCED REPRODUCTIVE SERVICES, P.C. | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $1450.00 | 1255793758 - MISSION SURGERY CENTER, INC. | 475137439 - (CA) MISSION SURGERY CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $747.00 | 1902431646 - CENTRAL OHIO ENDOSCOPY CENTER, LLC | 311674561 - (OH) CENTRAL OHIO ENDOSCOPY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $3500.00 | 1609870336 - DESOTO SURGICARE PARTNERS, LTD, NORTH TEXAS SURGERY CENTER | 752592508 - (TX) DESOTO SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $2250.00 | 1841759040 - BEAVER VALLEY AMBULATORY SURGERY CENTER, LLC | 822918272 - (PA) BEAVER VALLEY AMBULATORY SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $1592.00 | 1710952841 - ANDOCHICK SURGICAL CENTER LLC, PHYSICIANS SURGERY CENTER OF FREDERICK | 522239166 - (MD) ANDOCHICK SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $630.00 | 1285333914 - ARIZONA SURGICAL SPECIALISTS CENTER, LLC, ARIZONA SURGICAL SPECIALISTS CENTER, LLC - SCOTTSDALE | 760737449 - (AZ) ARIZONA SURGICAL SPECIALISTS CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $1272.00 | 1144607862 - DEKALB SURGICAL SERVICES, LLC | 471088369 - (IL) DEKALB SURGICAL SERVICES LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $1333.00 | 1427005313 - WESTERN WASHINGTON MEDICAL GROUP, INC PS, WESTERN WASHINGTON MEDICAL GROUP ENDOSCOPY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $1710.00 | 1013468586 - LAKEWAY AMBULATORY SURGERY CENTER, LLC, LAKEWAY SURGERY CENTER | 383992761 - (TX) LAKEWAY AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $2000.00 | 1235466863 - AESTHETIC ASSOCIATES INC., P.S, SEATTLE FACIAL PLASTIC SURGERY CENTER | 911650765 - (WA) AESTHETIC ASSOCIATES INC PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52224 | $1505.00 | 1356383640 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE CENTER | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 52224 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52224 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 52224 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 |
|---|---|---|
| 52214-CPT | Moderate | Cystourethroscopy, With Fulguration (Including Cryosurgery Or Laser Surgery) Of Trigone, Bladder Neck, Prostatic Fossa, Urethra, Or Periurethral Glands |
| 52224-CPT | Moderate | Cystourethroscopy, With Fulguration (Including Cryosurgery Or Laser Surgery) Or Treatment Of Minor (Less Than 0.5 Cm) Lesion(S) With Or Without Biopsy |
| 52234-CPT | Moderate | Cystourethroscopy, With Fulguration (Including Cryosurgery Or Laser Surgery) And/Or Resection Of; Small Bladder Tumor(S) (0.5 Up To 2.0 Cm) |
| 52235-CPT | Moderate | Cystourethroscopy, With Fulguration (Including Cryosurgery Or Laser Surgery) And/Or Resection Of; Medium Bladder Tumor(S) (2.0 To 5.0 Cm) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52224. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52224 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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