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 |
| CMS | $253.92 Physician Fee Schedule |
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 | $1530.00 | 1760465207 - PLASTIC SURGICAL CENTER OF RAPID CITY, PROF. L.L.C. | 460441899 - (SD) PLASTIC SURGICAL CENTER OF RAPID CITY PROF LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $1200.00 | 1396142733 - DIALYSIS ACCESS SERVICES, LLC | 472322456 - (MD) DIALYSIS ACCESS SERVICES LLC | MD | 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 | $1283.00 | 1306134838 - ASC DEVELOPMENT COMPANY LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | 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 | $1048.00 | 1205917101 - CATARACT & LASER CENTER, INC. | 42907424 - (MA) THE CATARACT AND LASER CENTER, I | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $1000.00 | 1497117113 - FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER, LLC | 352551684 - (PA) FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $1093.00 | 1902095417 - PERIMETER SURGICAL CENTER INC | 260698992 - (OH) PERIMETER SURGICAL CENTER INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $1212.00 | 1447442348 - TIMOTHY P. CAREY M.D. INC. P.S. | 910870414 - (WA) TIMOTHY P CAREY MD INC PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $1926.00 | 1720572415 - APC-AMARILLO SURGICAL OPERATING COMPANY, LLC, ADVANCED SURGICAL CENTER - AMARILLO | 822413483 - (TX) APCAMARILLO SURGICAL OPERATING COMPANY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $2231.00 | 1154945921 - MONTANA ENDOSCOPY CENTER, PLLC | 843703860 - (MT) MONTANA ENDOSCOPY CENTER PLLC | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $525.00 | 1992845283 - CHESAPEAKE AMBULATORY SURGERY CENTER | 522240631 - (MD) CHESAPEAKE AMBULATORY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $846.00 | 1710151063 - HENDI AMBULATORY SURGERY CENTER, PC | 262238944 - (MD) HENDI AMBULATORY SURGERY CENTER PC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52402 | $791.00 | 1962459610 - CENTRAL TEXAS DAY SURGERY CENTER LIMITED PARTNERSHIP | 752477808 - (TX) CENTRAL TEXAS DAY SURGERY CENTER LIMITED PARTNERSHIP | TX | 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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