Price Checker / CPT 52204

CPT 52204Cystoscopy w/biopsy(s)

2026 Medicare Physician Fee Schedule rates and hospital pricing data

Medicare Rate (Facility)

$127

What Medicare pays in a hospital/ASC setting

Medicare Rate (Office)

$355

What Medicare pays in a physician's office

Avg Hospital Charge

$15,640

Based on 12 hospital(s) in our database

What do these numbers mean?

The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.

Hospital Charges for CPT 52204

From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.

HospitalGross ChargeCash Ratevs Medicare
Los Alamos Medical Center

, NY

$29,8118288%
"Woman's Hospital"

, CA

$23,370$23,3556476%
Franciscan Health Rensselaer

, IN

$21,549$8,8575963%
Union Hospital Terre Haute

Terre Haute, IN

$20,8015753%
Georgetown Community Hospital

, KY

$18,8815213%
Bourbon Community Hospital

, KY

$17,2344749%
Lake Cumberland Regional Hospital

, CO

$16,8824650%
EHHS Fulton Square Clinic

, WI

$12,504$9,1283418%
Spring View Hospital

, KY

$11,5533151%
LifeBrite Community Hospital of Stokes

, NC

$7,8291882%
Wills Memorial Hospital

, GA

$4,095$2,8671052%
Richardson Medical Center

, LA

$3,174$2,381793%

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About CPT 52204

CPT code 52204 refers to “Cystoscopy w/biopsy(s)”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $127 in a facility (hospital or ambulatory surgery center) and $355in a non-facility (physician's office) setting.

These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.

What to do if you were overcharged

  1. Upload your bill— we'll identify this code and compare it against the rates shown above.
  2. Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
  3. Negotiate or let us handle it — 25% of savings, no savings = no fee.

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