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See a sample rate comparisonCPT 52235 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.
Cystourethroscopy With Fulgur, Cystourethroscopy With Fulguration (Including Cryosurgeryor Laser Surgery) Andor Resection Of Medium Bladder Tumor(S) (2.0 To 5.0 Cm)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None GC - Service performed by resident under supervision 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52235 |
| Medicaid Fee Schedule | View Medicaid rates for 52235 |
National average reimbursement for CPT 52235 by major payers:
$370.95
$393.44
$431.87
$475.11
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CPT 52235
5 of 25 sample ratesHigher to lower in this preview
Baptist Surgery Center Lp, Baptist Ambulatory Surgery Center
Baptist Surgery Center Lp
$3,514.00Published rateRiver North Same Day Surgery LLC, Northwestern Medicine Surgery Center River North
$2,271.00Published rateUrlogy Ambulatory Surgery Center LLC, Wolf River Surgery Center
Urlogy Ambulatory Surgery Center LLC
$1,212.00Published rateGlastonbury Endoscopy Center, LLC
Glastonbury Endoscopy Center LLC
$692.00Published rateClaire Sutherby
Deaconess Hospital Inc
$238.36Published rate
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See a sample payer proposalCPT 52235 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52235 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 52235 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 |
|---|---|---|
| 52224-CPT | Moderate | Cystourethroscopy With Fulgur, Cystourethroscopy With Fulguration (Including Cryosurgeryor Laser Surgery) Or Treatment Of Minor (Less Than 0.5 Cm) Lesion(S) With Or Without Biopsy |
| 52234-CPT | Moderate | Cystoscopy And Treatment, 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 Fulgur, Cystourethroscopy With Fulguration (Including Cryosurgeryor Laser Surgery) Andor Resection Of Medium Bladder Tumor(S) (2.0 To 5.0 Cm) |
| 52240-CPT | Moderate | Cystourethroscopy With Fulgur, Cystourethroscopy With Fulguration (Including Cryosurgeryor Laser Surgery) Andor Resection Of Large Bladder Tumor(S) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52235. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52235 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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