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CPT 52275 Fee Schedule

Last Verified: December 2025

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.

C-Uscopy W Int Urethrotomy Male
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Urinary System

Common Place of Service

11 - Office

22 - On Campus Outpatient Hospital

Common Modifiers

None

59 - Distinct Procedural Service

51 - Multiple procedures

Complexity LevelModerate

National average reimbursement for CPT 52275 by major payers:

bcbs

$651.75

uhc

$713.32

aetna

$745.75

cigna

$864.40

Preview provider-level rates for...
For billing codeCPT 52275
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 52275

United
52275$2353.001841395894 - FRANKLIN ENDOSCOPY CENTER, LLC, FRANKLIN ENDOSCOPY CENTER383730672 - (TN) FRANKLIN ENDOSCOPY CENTER LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$983.001174850176 - SOUTHWEST OHIO PAIN MANAGEMENT LLC300571536 - (OH) SOUTHWEST OHIO PAIN MANAGEMENTOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$1708.001023297553 - PHYSICIANS SURGERY CENTER, LLC260425547 - (IL) PHYSICIANS SURGERY CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$2859.001891450805 - NORTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLC364920288 - (CO) NORTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$1180.001518450790 - VIRGINIA ENT SURGERY CENTER INC825301397 - (VA) VIRGINIA ENT SURGERY CENTER INCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$5085.831538223714 - SAINT VINCENT HLTH CTR SPU250965547 - (PA) HIGHMARK HEALTHPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$818.001497347934 - INTEGRIS DDSI ENDOSCOPY CENTERS LLC854253589OKAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$3829.001255936761 - CROWN POINT SURGICAL SUITES, LLC851476511 - (IN) CROWN POINT SURGICAL SUITES LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$542.001114177417 - NISENFELD & CHILTON, MD PA, ORTHOPAEDIC ASSOCIATES OF FREDERICK, ASC521135399 - (MD) NISENFELD & CHILTON, M.D., P.A.MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$1850.001003116823 - NORTHERN N.J. ENDOSCOPY CENTER, L.L.C.640955113 - (NJ) NORTHERN NJ ENDOSCOPY CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$830.001730153073 - EAST MEMPHIS UROLOGY CENTER, LP, UROCENTER621810940 - (TN) EAST MEMPHIS UROLOGY CENTER LPTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$892.961255530317 - APRIL TOELLE350593390 - DEACONESS HOSPITAL INCINHospitalist Physician (208M00000X)
United
52275$1129.001093276859 - JACKSONVILLE OUTPATIENT SURGERY CENTER, LLC833910772 - (FL) JACKSONVILLE OUTPATIENT SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$632.501184937468 - GRASS VALLEY OUTPATIENT SURGERY CENTER LP, GRASS VALLEY SURGERY CENTER272185264CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
52275$2300.001437794625 - VANCE THOMPSON VISION SURGERY CENTER BILLINGS, LLC843362063MTAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 52275 vs. Other Surgical Procedures on the Urinary System Codes

The CPT 52275 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 52275 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.

CodeComplexityDescription
52270-CPTModerateCystourethroscopy W Internal Urethrotomy
52275-CPTModerateC-Uscopy W Int Urethrotomy Male
52276-CPTModerateCystourethroscopy W Direc Vision Interna
52277-CPTModerateC-Uscopy W Sphincterotomy

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52275. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 52275 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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