CPT code 52315: Cystoscopic removal, complicated extraction2026 Medicare rate & RVUs

Medicare pays $457.59 for 52315 nationally in the office and $242.49 in a hospital or facility. Local office rates run $409.25–$583.35.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 52315 covers

A urologist uses a cystoscope passed through the urethra to remove a foreign body, calculus, or ureteral stent from the urethra or bladder. The complicated service may involve difficult retrieval, such as extracting an encrusted stent or an object that cannot be removed with straightforward grasping. It is performed in settings such as an office procedure room or a hospital or ambulatory surgery facility, depending on the patient and procedure.

Choose this code rather than the simpler removal code when the operative note supports a complicated extraction; the diagnosis alone does not establish the level. Document the object or stent location, the removal technique, and the circumstances that made retrieval complicated. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate. Medicare does not pay for an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 52315 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

52315 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 52315 rate is calculated

Each of 52315’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 52315

The CMS indicators that decide how 52315 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

52315 compared with similar codes

How to choose

52310Cystoscopic removalSimple urethral or bladder removal

Both cover cystoscopic removal from the urethra or bladder, but 52315 is for complicated extraction. Select based on the documented procedural complexity, not just the diagnosis.

52317Bladder stone removalSmall or simple calculus

52317 describes bladder stone treatment by litholapaxy. Use 52315 for complicated extraction of a calculus from the urethra or bladder when the service is not litholapaxy.

52318Bladder stone removalLarge or complicated stone

52318 is for more extensive bladder stone litholapaxy. It is not the code for complicated removal of a stent or other foreign body.

52352UreteroscopyStone removal or manipulation

52352 involves ureteroscopic stone removal. This code is for complicated removal of a foreign body, calculus, or stent located in the urethra or bladder.

Codes related to 52315

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates