CPT 52276 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52276 |
National average reimbursement for CPT 52276 by major payers:
$339.57
$364.04
$390.29
$445.88
| 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 52276 | ||||||
United | 52276 | $995.00 | 1144482753 - CLARKSVILLE EYE SURGERY CENTER | 261815638 - (TN) CLARKSVILLE EYE SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52276 | $2007.00 | 1992238661 - OPTIMUM SURGICAL CENTER, LLC, NASCENT PARADISE VALLEY SURGICAL CENTER | 814730990 - (AZ) OPTIMUM SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52276 | $4141.00 | 1184877219 - THR/STT ROCKWALL ASC, LLC | 262429878 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52276 | $3500.00 | 1245798826 - SURGCENTER OF GREATER DALLAS, LLC., SURGCENTER OF GREATER DALLAS | 831498677 - (TX) SURGCENTER OF GREATER DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52276 | $1700.00 | 1790145480 - TWIN CITIES SURGERY CENTER | 463311193 - (MN) TWIN CITIES SURGERY CENTER | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52276 | $2206.00 | 1407275282 - SURGCENTER CAMELBACK LLC | 464169482 - (AZ) SURGCENTER CAMELBACK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52276 | $632.50 | 1538386743 - HOWARD S BARNEBEY MD, SPECIALY EYECARE CENTRE | 911357221 - (WA) SPECIALTY EYE CARE CENTRE | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52276 | $475.88 | 1851736268 - STEVEN VONFROLIO | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 52276 | $218.64 | 1083073035 - LILLIAN SILVA | 350593390 - DEACONESS HOSPITAL INC | VA | Certified Registered Nurse Anesthetist (367500000X) |
United | 52276 | $1658.00 | 1790265999 - MUVE | 822351627 - (PA) MUVE | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52276 | $925.00 | 1053508077 - JOURNEY LITE OF CINCINNATI, LLC | 208861350 - (OH) JOURNEYLITE OF CINCINNATI, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52276 | $475.88 | 1346778297 - JASDIP GREWAL | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 52276 | $1413.00 | 1417566217 - CLEARWAY SURGERY CENTER OF EASTON, LLC | 851826166 - (MD) CLEARWAY SURGERY CENTER OF EASTON LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52276 | $632.50 | 1124587548 - GATEWAY SURGICAL CENTER, LLC | 830521568 - (TX) GATEWAY SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52276 | $2432.00 | 1194813840 - SURGERY CENTER OF WISCONSIN RAPIDS, LLC | 203672837 - (WI) SURGERY CENTER OF WISCONSIN RAPIDS LLC | WI | 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 52276 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52276 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 52276 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 |
|---|---|---|
| 52275-CPT | Moderate | C-Uscopy W Int Urethrotomy Male |
| 52276-CPT | Moderate | Cystourethroscopy W Direc Vision Interna |
| 52277-CPT | Moderate | C-Uscopy W Sphincterotomy |
| 52281-CPT | Moderate | Cystourethroscopy, With Calibration And/Or Dilation Of Urethral Stricture Or Stenosis, With Or Without Meatotomy, With Or Without Injection Procedure For Cystography, Male Or Female |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52276. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52276 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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