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See a sample rate comparisonCPT 52281 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None 59 - Distinct Procedural Service SG - Scene to Hospital ESRD facility |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52281 |
| Medicaid Fee Schedule | View Medicaid rates for 52281 |
National average reimbursement for CPT 52281 by major payers:
$375.72
$418.85
$463.74
$520.10
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CPT 52281
5 of 25 sample ratesHigher to lower in this preview
Disc Surgery Center At Marina Del Rey LLC
$5,000.00Published rateSurgical Suites Of Coastal Virginia, LLC
Surgical Suites Of Coastal Virginia LLC
$2,013.00Published rateMed Atlantic Inc, Med Atlantic Inc Dba Urosurgical Ctr Of Richmond
$1,114.00Published rateArizona Endoscopy Center, LLC
Arizona Endoscopy Center LLC
$605.00Published rateSpringhill Surgery Center, LLC
$411.00Published rate
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See a sample payer proposalCPT 52281 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52281 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 52281 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 52281. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52281 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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