CPT 52284 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 |
| Complexity Level | Moderate |
| CMS | $2,466.74 Physician Fee Schedule |
National average reimbursement for CPT 52284 by major payers:
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| 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 52284 | ||||||
United | 52284 | $1100.00 | 1669031886 - SURGICAL CLINIC SOLUTIONS, LLC | 823722886 - (AL) SURGICAL CLINIC SOLUTIONS | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $2859.00 | 1205361052 - MINIMALLY INVASIVE SURGERY CENTER OF N.E., LLC | 815005653 | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $1400.00 | 1619559044 - ASCENT SURGERY CENTER, LLC | 853327359 - (OH) ASCENT SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $1343.00 | 1932321882 - DIGESTIVE HEALTH CENTER OF HUNTINGTON | 811030907 - (NY) DHCH, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $917.00 | 1376729715 - ENDOSCOPY ASSOCIATES OF VALLEY FORGE, LLC | 161770779 - (PA) ENDOSCOPY ASSOCIATES OF VALLEY FORGE LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $1100.00 | 1578914891 - DH PHYSICIANS AMBULATORY SERVICES | 812885619 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $2007.00 | 1336131143 - PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC, GATEWAY SURGERY CENTER | 860970374 - (AZ) PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $2206.00 | 1558879684 - DELAWARE RIVER SURGICAL SUITES, LLC | 822713553 - (PA) BUCKS COUNTY SURGICAL SUITES | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $4263.00 | 1386165504 - THE EMORY CLINIC INC, EMORY AMBULATORY SURGERY CENTER AT SPIVEY STATION | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $2388.00 | 1851950281 - YUMA ADVANCED SURGICAL SUITES LLC | 833076801 - (AZ) YUMA ADVANCED SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $1477.00 | 1669021283 - EL DORADO SURGERY CENTER LP, TUCSON ENDOSCOPY CENTER | 850474225 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $2859.00 | 1336246099 - VALLEY BAPTIST AMBULATORY SURGERY CENTER, LLC, PLATINUM SURGERY CENTER | 871904768 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $2595.00 | 1801987805 - ENDO SURGI CENTER OF OLD BRIDGE LLC | 223679920 - (NJ) ENDO-SURGI CENTER OF OLD BRIDGE, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $2859.00 | 1275532889 - COAST SURGERY CENTER L P, COAST SURGERY CENTER OF SOUTH BAY | 450463066 - (CA) COAST SURGERY CENTER L P | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52284 | $1148.00 | 1477516532 - SPECIALTY SURGICARE OF LAS VEGAS, LP | 260116160 | NV | 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 52284 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52284 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 52284 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 |
|---|---|---|
| 52284-CPT | Moderate | Cystourethroscopy, With Mechanical Urethral Dilation And Urethral Therapeutic Drug Delivery By Drug-Coated Balloon Catheter For Urethral Stricture Or Stenosis, Male, Including Fluoroscopy, When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52284. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52284 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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