Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 52250 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 Inserti, Cystourethroscopy With Insertion Of Radioactive Substancewith Or Without Biopsy Or Fulguration Cystourethroscopy With Insertion Of Radioactive Substance
| 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 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52250 |
| Medicaid Fee Schedule | View Medicaid rates for 52250 |
National average reimbursement for CPT 52250 by major payers:
$327.10
$325.33
$330.37
$390.86
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 52250.
CPT 52250
5 of 25 sample ratesHigher to lower in this preview
Rock Hill Surgery Center, LLC, Carolina Surgical Center
Rock Hill Surgery Center LLC
$13,579.00Published rateAdvanced Surgical Care Of Boerne, LLC
Advanced Surgical Care Of Boerne LLC
$2,859.00Published rateNorth Point Surgery Center, LLC
North Point Surgery Center LLC
$1,416.00Published rateSalvatore Dimercurio Md PA
Salvatore Dimercurio, M.D., P.A.
$746.00Published rateJared Jones
Deaconess Hospital Inc
$430.60Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 52250 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52250 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 52250 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) |
| 52240-CPT | Moderate | Cystourethroscopy With Fulgur, Cystourethroscopy With Fulguration (Including Cryosurgeryor Laser Surgery) Andor Resection Of Large Bladder Tumor(S) |
| 52250-CPT | Moderate | Cystourethroscopy With Inserti, Cystourethroscopy With Insertion Of Radioactive Substancewith Or Without Biopsy Or Fulguration Cystourethroscopy With Insertion Of Radioactive Substance |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52250. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52250 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 52250) and we'll show you how you compare in 15 minutes or less.