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See a sample rate comparisonCPT 52442 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.
Cysto Ins Trnsprstc Implt Ea, Cystourethroscopy With Insertion Of Permanent Adjustable Transprostatic Implant; Each Additional Permanent Adjustable Transprostatic Implant (List Separately In Addition To Code For Primary Procedure)
| 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 11 - Office |
| Common Modifiers | None 59 - Distinct Procedural Service SG - Scene to Hospital ESRD facility |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52442 |
| Medicaid Fee Schedule | View Medicaid rates for 52442 |
National average reimbursement for CPT 52442 by major payers:
$940.72
$1,273.96
$1,313.80
$191.26
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CPT 52442
5 of 25 sample ratesHigher to lower in this preview
Ku Medwest Ambulatory Surgery Center, LLC
Ku Medwest Ambulatory Surgery Center LLC
$2,321.00Published rateCatherine Pfeiffer
St Peters Hospital
$1,632.47Published rateCarah Whichard
St Peters Health Partners Medical Associates PC
$1,387.66Published rateSandra Hermans
Albany Med Health System
$862.26Published rateLakewood Eye Physicians And Surgeons Inc A Medical Group
Lakewood Eye Physicians & Surgeons, Inc.
$97.00Published rate
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See a sample payer proposalCPT 52442 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52442 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 52442 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 |
|---|---|---|
| 52441-CPT | High | Once Per Dos Cystourethroscopy, W/Insertion Of Permanent Adjustable Transprostatic Implant; Single Implant- Rn Review >=5/1/2018; Deny Inv/N10=3/11/2016-4/30/2018 |
| 52442-CPT | Moderate | Cysto Ins Trnsprstc Implt Ea, Cystourethroscopy With Insertion Of Permanent Adjustable Transprostatic Implant; Each Additional Permanent Adjustable Transprostatic Implant (List Separately In Addition To Code For Primary Procedure) |
| 52601-CPT | Moderate | Prostatectomy Turp, Transurethral Electrosurgical Resection Of Prostate Including Control Of Postoperative Bleeding Complete Vasectomy Meatotomy Cystourethroscopy Urethral Calibration And Or Dilation And Internal Urethrotomy Are Included |
| 52630-CPT | Moderate | Remove Prostate Regrowth, Transurethral Resection Residual Or Regrowth Of Obstructive Prostate Tissue 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 52442. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52442 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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