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See a sample rate comparisonCPT 52276 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 Direct, Cystourethroscopy With Direct Vision Internal Urethrotomycystourethroscopy With Direct Vision Internal Urethrotomy
| 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 |
| Medicaid Fee Schedule | View Medicaid rates for 52276 |
National average reimbursement for CPT 52276 by major payers:
$339.57
$364.04
$390.29
$435.25
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CPT 52276
5 of 25 sample ratesHigher to lower in this preview
Thr/Stt Rockwall Asc, LLC
$4,141.00Published rateTamarac Surgery Center LLC, The Surgery Center Of Ft Lauderdale
Tamarac Surgery Center LLC
$2,388.00Published rateColumbia Asc LLC, Columbia Gastrointestinal Endoscopy Center
The Columbia Asc, LLC
$1,495.00Published rateJourney Lite Of Cincinnati, LLC
Journeylite Of Cincinnati, LLC
$925.00Published rateLillian Silva
Deaconess Hospital Inc
$218.64Published rate
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See a sample payer proposalCPT 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 | Scope Surgery On Urinary Tract, Surgery Aided By A Scope (Cystourethroscopy) To Find And Remove A Blockage From The Urinary Tract. |
| 52276-CPT | Moderate | Cystourethroscopy With Direct, Cystourethroscopy With Direct Vision Internal Urethrotomycystourethroscopy With Direct Vision Internal Urethrotomy |
| 52277-CPT | Moderate | Scope Surgery On Urine Tract, Surgery On The Urinary Tract Aided By A Scope (Cystourethroscopy). The Procedure Cuts A Valve Muscle That Controls Release Of Urine. |
| 52281-CPT | Moderate | Cystoscopy And Treatment, 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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