CPT 52204

Cystourethroscopy With Biopsy

CPT 52204 pays $355.39 in a non-facility setting and $126.92 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $313.28 in Arkansas to $409.41 in Alaska, a 31% spread.

National non-facility rate

$355.39

Office and other outpatient settings

Facility rate
$126.92

Hospital and ASC settings

Highest state
$409.41

Alaska

Lowest state
$313.28

Arkansas · 31% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $355.39
CPT 52204 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $355.39, national facility $126.92.
StateRate compared visuallyNon-facilityFacility
Alaska
$409.41$166.10
District of Columbia
$407.43$138.30
California
$400.78$130.45
New York
$393.48$138.60
New Jersey
$393.37$136.13
Washington
$391.98$131.54
Massachusetts
$388.07$131.39
Hawaii
$386.16$126.40
Connecticut
$379.44$133.39
Colorado
$370.52$127.44
Maryland
$368.39$130.22
Florida
$367.00$137.78
Oregon
$366.81$126.12
New Hampshire
$364.61$126.78
Rhode Island
$364.33$128.33
Puerto Rico
$358.07$127.09
Virgin Islands
$358.07$127.09
Illinois
$357.27$136.52
Montana
$355.36$126.90
Minnesota
$354.92$119.83
Nevada
$353.75$125.06
Wyoming
$352.43$123.97
Pennsylvania
$351.61$127.83
Delaware
$351.55$125.83
Texas
$351.02$126.10
North Dakota
$348.64$120.18
South Dakota
$347.84$119.38
Virginia
$347.63$123.06
Vermont
$347.18$121.00
Georgia
$345.81$127.85
Arizona
$345.70$124.33
Michigan
$344.18$129.66
Maine
$339.60$121.30
Utah
$338.66$123.90
Wisconsin
$336.63$117.76
New Mexico
$336.13$126.63
South Carolina
$333.96$122.86
North Carolina
$333.90$120.74
Missouri
$333.84$124.19
Louisiana
$333.34$124.75
Ohio
$332.90$124.31
Indiana
$330.60$118.82
Idaho
$328.64$118.45
Nebraska
$328.34$117.47
Tennessee
$326.51$118.84
Iowa
$326.48$117.44
West Virginia
$326.28$127.75
Kentucky
$325.61$122.51
Oklahoma
$325.08$121.07
Kansas
$324.84$118.31
Alabama
$318.02$118.11
Mississippi
$316.35$119.64
Arkansas
$313.28$117.04

Billed by 1 specialties

Commercial rates for 52204

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates