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See a sample rate comparisonCPT 52265 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 Dilati, Cystourethroscopy With Dilation Of Bladder For Interstitialcystitis Local Anesthesia Cystourethroscopy With Dilation Of Bladder For Interstitial
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52265 |
| Medicaid Fee Schedule | View Medicaid rates for 52265 |
National average reimbursement for CPT 52265 by major payers:
$465.74
$530.10
$541.66
$307.44
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CPT 52265
5 of 25 sample ratesHigher to lower in this preview
Deaconess Hospital, Inc, <Unavail>
Deaconess Hospital Inc
$3,455.00Published rateValley Baptist Ambulatory Surgery Center, LLC, Platinum Surgery Center
$953.00Published rateDigestive Healthcare Of Georgia Endoscopy Center Mountainside
$500.00Published rateBuckeye South LLC, Buckeye Surgery Center
Buckeye South LLC
$323.00Published rateHazleton Ambulatory Surgical Center LLC
$200.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 52265 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52265 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 52265 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 |
|---|---|---|
| 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) |
| 52265-CPT | Moderate | Cystourethroscopy With Dilati, Cystourethroscopy With Dilation Of Bladder For Interstitialcystitis Local Anesthesia Cystourethroscopy With Dilation Of Bladder For Interstitial |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52265. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52265 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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