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CPT 52204 — Cystoscopy w/biopsy(s)

CPT code 52204 (Cystoscopy w/biopsy(s)) carries 2.53 work RVUs under the CMS 2026 Medicare Physician Fee Schedule. Total RVUs are 10.64 in a non-facility setting and 3.8 in a facility setting, which at the 2026 conversion factor of $33.40 works out to $355.39 and $126.92 respectively.

2.53
Work RVU
10.64
Total RVU (non-facility)
$355.39
Medicare, non-facility
$126.92
Medicare, facility
Calculate your total wRVUs →

RVU breakdown for CPT 52204

ComponentRVUsWhat it covers
Work RVU2.53Physician time, skill, effort, and stress.
Practice expense RVU (non-facility)7.77Office overhead, staff, supplies.
Practice expense RVU (facility)0.93Overhead when performed in a hospital.
Malpractice RVU0.34Professional liability cost.
Total RVU (non-facility)10.64Work + non-facility PE + malpractice.
Total RVU (facility)3.8Work + facility PE + malpractice.

How Medicare payment is calculated

Medicare multiplies total RVUs by the annual conversion factor. For CPT 52204 in 2026:

SettingTotal RVUConversion factorNational payment
Non-facility10.64$33.40$355.39
Facility3.8$33.40$126.92

These are national amounts. Actual payment is adjusted by the Geographic Practice Cost Index for your locality — check yours with the GPCI lookup.

Billing rules for CPT 52204

Global period
0-day global — no pre- or post-operative period included.
Multiple procedure reduction
Subject to the multiple-endoscopy payment rule.
Bilateral surgery
Bilateral adjustment does not apply.
Assistant surgeon
Not permitted.
Co-surgeon
Not permitted unless documentation supports medical necessity.
Team surgery
Not permitted unless documentation supports medical necessity.

Questions about CPT 52204

How many work RVUs is CPT 52204?

CPT 52204 is assigned 2.53 work RVUs in the CMS 2026 Medicare Physician Fee Schedule.

What does Medicare pay for CPT 52204?

At the 2026 national conversion factor of $33.40, CPT 52204 pays approximately $355.39 in a non-facility setting and $126.92 in a facility setting before geographic adjustment.

What is the global period for CPT 52204?

0-day global — no pre- or post-operative period included.

RVU values reflect the CMS 2026 Medicare Physician Fee Schedule (conversion factor $33.40). Payment figures are national and unadjusted for geography. Verify against the official fee schedule before using for billing.