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See a sample rate comparisonCPT 52400 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 Incisio, Cystourethroscopy With Incision Fulguration Or Resection Of Congenital Posterior Urethral Valves Or Congenital Obstructive Hypertrophic Mucosal Folds
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Urinary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52400 |
| Medicaid Fee Schedule | View Medicaid rates for 52400 |
National average reimbursement for CPT 52400 by major payers:
$644.84
$659.69
$687.62
$790.92
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CPT 52400
5 of 25 sample ratesHigher to lower in this preview
Alpine Surgicenter, LLC
$7,011.00Published rateSurgery Centre Of Sw Florida LLC, Cape Health Surgery Center
$2,353.00Published rateYorkville Endoscopy, LLC
Yorkville Endoscopy LLC
$1,810.00Published rateMetairie La Endoscopy Asc LLC, Mga Gastrointestinal Diagnostic And Therapeutic Center-Metairie
$1,102.00Published rateSouthwest Cardiovascular Interventional Center, LLC
Southwest Cardiovascular Interventional Center LLC
$845.00Published rate
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See a sample payer proposalCPT 52400 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52400 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 52400 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 |
|---|---|---|
| 52341-CPT | Moderate | Treat Narrowed Urinary Tract, Exam Of The Upper Urinary Tract Using A Scope (Cystourethroscopy). The Procedure Treats A Section Of The Urinary Tract That Has Become Too Narrow For Urine To Flow Freely. |
| 52400-CPT | Moderate | Cystourethroscopy With Incisio, Cystourethroscopy With Incision Fulguration Or Resection Of Congenital Posterior Urethral Valves Or Congenital Obstructive Hypertrophic Mucosal Folds |
| 53000-CPT | Low | Urethrotomy Or Urethrostomy Xtrnal (Sepa Proc); Pendulous, Urethrotomy Or Urethrostomy External (Separate Procedure); Pendulous |
| 53020-CPT | Low | Meatotomy Ex Infant Office |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52400. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52400 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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