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See a sample rate comparisonCPT 52285 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 For Treatment Of The Female Urethral Syndrome With Any Or All Of The Following Urethral Meatotomy Urethral Dilation Internal Urethrotomy Lysis Of Urethrovaginal Septal Fibrosis Lateral Incisions Of The Bladder Neck And Fulguration Of Polyp S Of Urethra Bladder Neck And Or Trigone
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52285 |
| Medicaid Fee Schedule | View Medicaid rates for 52285 |
National average reimbursement for CPT 52285 by major payers:
$386.05
$410.85
$453.88
$342.47
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CPT 52285
5 of 25 sample ratesHigher to lower in this preview
Crozer-Chester Medical Center
$2,575.00Published rateDelaware River Surgical Suites, LLC
Bucks County Surgical Suites
$1,179.00Published rateEl Paso Asc Lp, Endoscopy Center Of El Paso
El Paso Asc Lp
$715.00Published rateCascade Surgery Center LLC
$540.00Published rateThanhtam Nguyen
Deaconess Hospital Inc
$245.94Published rate
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See a sample payer proposalCPT 52285 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52285 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 52285 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 |
|---|---|---|
| 52276-CPT | Moderate | Cystourethroscopy With Direct, Cystourethroscopy With Direct Vision Internal Urethrotomycystourethroscopy With Direct Vision Internal Urethrotomy |
| 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 |
| 52282-CPT | Moderate | Insert Urinary Tract Support, A Bladder Exam Using A Scope (Cystourethroscope). The Procedure Inserts A Support Device (Stent) Into The Urinary Tract. |
| 52285-CPT | Moderate | Cystoscopy And Treatment, Cystourethroscopy For Treatment Of The Female Urethral Syndrome With Any Or All Of The Following Urethral Meatotomy Urethral Dilation Internal Urethrotomy Lysis Of Urethrovaginal Septal Fibrosis Lateral Incisions Of The Bladder Neck And Fulguration Of Polyp S Of Urethra Bladder Neck And Or Trigone |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52285. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52285 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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