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See a sample rate comparisonCPT 52630 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.
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
| 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 78 - Return to OR - related procedure 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52630 |
| Medicaid Fee Schedule | View Medicaid rates for 52630 |
National average reimbursement for CPT 52630 by major payers:
$543.21
$556.80
$604.14
$679.18
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CPT 52630
5 of 25 sample ratesHigher to lower in this preview
St. Joseph Regional Health Center
St Joseph Regional Health Center
$11,958.00Published rateColorado Urologic Surgery Center LLC
$5,433.00Published rateAghapy Surgical Center Sc
$2,848.00Published rateFrederick Surgical Center, LLC
Frederick Surgical Center LLC
$1,855.00Published rateMatthew Fury
$406.83Published rate
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See a sample payer proposalCPT 52630 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52630 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 52630 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 |
|---|---|---|
| 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 |
| 52640-CPT | Moderate | Transurethral Resection Of Po, Transurethral Resection Of Postoperative Bladder Neckcontracture Transurethral Resection Of Postoperative Bladder Neck |
| 52648-CPT | High | Laser Surgery Of Prostate, Laser Vaporization Of Prostate Including Control Of Postoperative Bleeding Complete Vasectomy Meatotomy Cystourethroscopy Urethral Calibration And Or Dilation Internal Urethrotomy And Transurethral Resection Of Prostate Are Included If Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52630 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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