CPT 52402 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 |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • SG - Scene to Hospital ESRD facility • 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52402 |
National average reimbursement for CPT 52402 by major payers:
$338.40
$362.35
$367.29
$454.37
| 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 52402 | ||||||
United | 52402 | $898.00 | 1215994280 - SLOAN EYE CLINIC, ARKANSAS SURGERY CENTER | 710815680 - (AR) SLOAN EYE CLINIC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $1258.00 | 1992451389 - NRH PAIN MANAGEMENT GROUP LLC, CASTLE SURGERY CENTER | 844029943 - (TX) NRH PAIN MANAGEMENT GROUP LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $475.00 | 1356311419 - RIVERSIDE AMBULATORY SURGERY CENTER LLC | 522233625 - (MD) RIVERSIDE AMBULATORY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $6245.00 | 1215060546 - TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE | 751752253 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILLE | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $1292.00 | 1780764829 - NOVAMED SURGERY CENTER OF ST PETERS LLC, ST PETERS AMBULATORY SURGERY CENTER | 205579933 - (MO) NOVAMED SURGERY CENTER OF ST PETERS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $2523.00 | 1831109560 - NEW MEXICO ORTHOPAEDIC SURGERY CENTER, LLC, NEW MEXICO SURGERY CENTER ORTHOPAEDICS | 621797896 | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $1203.00 | 1528130879 - PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT | 330776873 - (CA) PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $1518.00 | 1558564344 - SURGERY CENTER OF ATLANTIS LLC | 260298828 - (FL) SURGERY CENTER OF ATLANTIS LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $2003.00 | 1316379647 - MINNESOTA EYE LASER & SURGERY CENTERS, LLC, MINNESOTA EYE LASER & SURGERY CENTERS | 460505033 - (MN) MINNESOTA EYE LASER SURGERY CENTERS LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $1170.00 | 1417937756 - CLEVELAND ASC LLC, CLEVELAND SURGICAL SUITES | 621647411 - (OH) CLEVELAND ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $4041.00 | 1386165504 - THE EMORY CLINIC INC, EMORY AMBULATORY SURGERY CENTER AT SPIVEY STATION | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $751.00 | 1720227176 - ST. AGNES HEALTHCARE, INC., GEORGE THOMAS GRACE M.D. SURGERY CENTER | 520591657 - ST AGNES HEALTHCARE INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $8705.00 | 1477846145 - INDIANA UNIVERSITY HEALTH SAXONY SURGERY CENTER LLC, SAXONY SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $2090.00 | 1124125331 - AMBULATORY SURGERY ASSOCIATES, LLC, BROOKSIDE SURGERY CENTER | 383237596 - (MI) AMBULATORY SURGERY ASSOCIATES | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $2748.00 | 1841920683 - ENDOSCOPY CENTER OF BEVERLY HILLS LLC | 872038458 - ENDOSCOPY CENTER OF BEVERLY HILLS LLC | CA | 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 52402 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52402 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 52402 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 |
|---|---|---|
| 52402-CPT | Moderate | Cystourethroscopy With Transurethral Resection Or Incision Of Ejaculatory Ducts |
| 52450-CPT | Moderate | Transurethral Incision Of Prostate |
| 52500-CPT | Moderate | Transurethral Resection Of Bladder Neck (Separate Procedure) |
| 52601-CPT | Moderate | Transurethral Electrosurgical Resection Of Prostate, Including Control Of Postoperative Bleeding, Complete (Vasectomy, Meatotomy, Cystourethroscopy, Urethral Calibration And/Or Dilation, And Internal Urethrotomy Are Included) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52402. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52402 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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