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CPT code 52315: Cystoscopic removal, complicated extraction2026 Medicare rate & RVUs in Washington, DC area

Report complicated cystourethroscopic extraction of a foreign body, calculus, or ureteral stent located in the urethra or bladder.

CMS RVU26DEffective Oct 1, 2026One payment locality4.8K Medicare services in 2024

In Washington, DC area, Medicare pays $516.59 for 52315 in the office and $263.20 when it’s performed in a hospital or facility.

$516.59Office (non-facility)
$263.20Hospital or facility
+12.9%vs the national office rate ($457.59)

Check a contract rate as a % of Medicare · 52315 nationwide

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

We’ll open 52315 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 52315 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Washington, DC area compares for 52315

Across 109 of 109 payment localities, the office rate for 52315 runs from $409.25 in Arkansas to $583.35 in San Benito County, CA. Washington, DC area pays $516.59. The RVUs are the same everywhere; the geographic indexes change the dollars.

52315 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$516.59
  2. Los Angeles, CA · California$505.67−$10.92
  3. Miami, FL · Florida$502.71−$13.88
  4. Chicago, IL · Illinois$489.09−$27.50
  5. Manhattan, NY · New York$524.62+$8.03
  6. Alaska · Alaska$549.50+$32.91
  7. Alabama · Alabama$414.65−$101.94

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

52315 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$409.25$224.48
ArizonaArizona$446.13$237.69
Bakersfield, CACalifornia$477.58$241.83
Chico, CACalifornia$475.61$239.86
El Centro, CACalifornia$475.72$239.97
Fresno, CACalifornia$475.61$239.86
Hanford, CACalifornia$475.61$239.86
Madera, CACalifornia$475.61$239.86

52315 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$409.25

$549.50

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
52315 office rate range by state
State / territoryOffice rate rangeLocalities
AK$549.501
AL$414.651
AR$409.251
AZ$446.131
CA$475.61–$583.3529
CO$471.741
CT$486.151
DC$516.591
DE$452.991
FL$457.15–$502.713
GA$433.17–$466.852
GU$484.601
HI$484.601
IA$421.501
ID$424.531
IL$447.06–$489.094
IN$426.681
KS$420.971
KY$426.181
LA$426.08–$444.952
MA$469.85–$513.652
MD$460.64–$516.593
ME$427.86–$446.942
MI$437.35–$463.642
MN$449.551
MO$420.32–$444.883
MS$414.801
MT$457.551
NC$431.701
ND$444.301
NE$423.201
NH$465.701
NJ$491.00–$512.322
NM$440.021
NV$454.121
NY$437.65–$537.865
OH$434.641
OK$424.151
OR$449.88–$484.082
PA$434.56–$475.862
PR$460.181
RI$467.171
SC$434.031
SD$442.731
TN$423.041
TX$432.08–$470.808
UT$439.361
VA$446.49–$516.592
VI$460.181
VT$443.881
WA$468.54–$522.322
WI$430.941
WV$432.411
WY$451.771

See 52315 in every payment locality

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.

How the rate is built · 52315

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.07

5.07 RVUs× 1.000 GPCI

Practice expense7.96

7.96 RVUs× 1.000 GPCI

Malpractice0.67

0.67 RVUs× 1.000 GPCI

Adjusted RVUs

13.7000

Conversion factor

$33.4009

Medicare rate

$457.59

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,135

Code
52315
Physician work
5.07
Practice expense
7.96
Malpractice
0.67

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 52315 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work5.07× 1.0545.3438
Practice expense7.96× 1.1789.3769
Malpractice0.67× 1.1130.7457
Total RVUs15.4664
Conversion factor× 33.4009

Office rate, Washington, DC area$516.59

Office: (5.07 × 1.054 + 7.96 × 1.178 + 0.67 × 1.113) × $33.4009 = $516.59

Facility: (5.07 × 1.054 + 1.52 × 1.178 + 0.67 × 1.113) × $33.4009 = $263.20

Open 52315 in the RVU calculator

Payment rules and modifiers for 52315

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

CMS payment indicators · 52315

Cystoscopic removal, complicated extraction

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

52315 without 51 · national office

$457.59

Cystoscopic removal, complicated extraction

52315-51 · Second procedure: 50%

$228.80

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 52315

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

Codes related to 52315
CodeHow it relatesOffice range, Washington, DC area
Same family
52310Cystoscopic removal, simple urethral or bladder removalSimpler removal of a foreign body, calculus, or ureteral stent from the urethra or bladder.$339.63
Used instead
52317Bladder stone removal, small or simple calculusBladder calculus treatment by litholapaxy when the stone is fragmented rather than extracted as a foreign body.$994.07
52318Bladder stone removal, large or complicated stoneMore extensive bladder calculus litholapaxy when fragmentation is performed.No office rate
52352Ureteroscopy, stone removal or manipulationUreteroscopic stone removal for a calculus in the ureter rather than the bladder or urethra.No office rate

How 52315 has changed in Washington, DC area

52315 · Office / nonfacility

$516.59

Effective 2026-10-01

The base rate is $18.88 higher than on 2025-10-01, moving from $497.71 to $516.59 (3.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $497.71changed to$516.59

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.20 changed to 5.07
    • Practice expense RVU 7.68 changed to 7.96
    • Malpractice RVU 0.63 changed to 0.67
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $534.80changed to$497.71

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.24 changed to 7.68
    • Malpractice RVU 0.64 changed to 0.63

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $526.07changed to$534.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $550.53changed to$526.07

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.21 changed to 8.24
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $571.60changed to$550.53

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.28 changed to 8.21
    • Malpractice RVU 0.62 changed to 0.64
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $574.18changed to$571.60

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.23 changed to 8.28

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $554.12changed to$574.18

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.48 changed to 8.23
    • Malpractice RVU 0.60 changed to 0.62
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $519.24changed to$554.12

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.84 changed to 7.48
    • Malpractice RVU 0.58 changed to 0.60
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $488.74changed to$519.24

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.15 changed to 6.84

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $482.38changed to$488.74

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.02 changed to 6.15
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $478.97changed to$482.38

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.95 changed to 6.02
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $480.70changed to$478.97

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $478.30changed to$480.70

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $466.92changed to$478.30

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.82 changed to 5.95
    • Malpractice RVU 0.48 changed to 0.58
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $460.37changed to$466.92

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.27 changed to 5.82
    • Malpractice RVU 0.50 changed to 0.48
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $460.37

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$516.59$263.20RVU26D
2026-07-01$516.59$263.20RVU26C
2026-04-01$516.59$263.20RVU26B
2026-01-01$516.59$263.20RVU26A
2025-10-01$497.71$290.66RVU25D
2025-07-01$497.71$290.66RVU25C
2025-04-01$497.71$290.66RVU25B
2025-01-01$497.71$290.66RVU25A
2024-10-01$534.80$297.12RVU24D
2024-07-01$534.80$297.12RVU24C
2024-04-01$534.80$297.12RVU24B
2024-03-09$534.80$297.12RVU24AR
2024-01-01$526.07$292.27RVU24A
2023-10-01$550.53$302.87RVU23D
2023-07-01$550.53$302.87RVU23C
2023-04-01$550.53$302.87RVU23B
2023-01-01$550.53$302.87RVU23A
2022-10-01$571.60$308.54RVU22D
2022-07-01$571.60$308.54RVU22C
2022-04-01$571.60$308.54RVU22B
2022-01-01$571.60$308.54RVU22A
2021-10-01$574.18$311.53RVU21D
2021-07-01$574.18$311.53RVU21C
2021-04-01$574.18$311.53RVU21B
2021-01-01$574.18$311.53RVU21A
2020-10-01$554.12$317.49RVU20D
2020-07-01$554.12$317.49RVU20C
2020-04-01$554.12$317.49RVU20B
2020-01-01$554.12$317.49RVU20A
2019-10-01$519.24$316.00RVU19D
2019-07-01$519.24$316.00RVU19C
2019-04-01$519.24$316.00RVU19B
2019-01-01$519.24$316.00RVU19A
2018-10-01$488.74$316.95RVU18D
2018-07-01$488.74$316.95RVU18C
2018-04-01$488.74$316.95RVU18B
2018-01-01$488.74$316.95RVU18AR1
2017-10-01$482.38$315.88RVU17D
2017-07-01$482.38$315.88RVU17C
2017-04-01$482.38$315.88RVU17B
2017-01-01$482.38$315.88RVU17A
2016-10-01$478.97$314.16RVU16D
2016-07-01$478.97$314.16RVU16C
2016-04-01$478.97$314.16RVU16B
2016-01-01$478.97$314.16RVU16A
2015-10-01$480.70$315.29RVU15D
2015-07-01$480.70$315.29RVU15C
2015-04-01$478.30$313.72RVU15B
2015-01-01$478.30$313.72RVU15A
2014-10-01$466.92$307.17RVU14D
2014-07-01$466.92$307.17RVU14C
2014-04-01$466.92$307.17RVU14B
2014-01-01$466.92$307.17RVU14A
2013-10-01$460.37$294.89RVU13D
2013-07-01$460.37$294.89RVU13C
2013-04-01$460.37$294.89RVU13B
2013-01-01$460.37$294.89RVU13AR

Price 52315 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

52315 billing questions

How does this differ from 52310?

52315 is for complicated removal of a foreign body, calculus, or ureteral stent from the urethra or bladder. Use 52310 for the corresponding simpler removal when the documented work supports that level.

Does an encrusted stent automatically qualify as complicated?

No. The operative documentation should describe the extraction difficulty and work performed; the presence of an encrusted stent by itself does not establish the code level.

Can this code be used for a ureteral stone removed with a ureteroscope?

No. This code concerns removal from the urethra or bladder. Ureteroscopic stone extraction is represented by a different procedure code, such as 52352, when its service is performed.

Should modifier 50 be appended for bilateral work?

No. Modifier 50 is inappropriate for this service.

How are related endoscopies priced when performed together?

CMS applies endoscopy family pricing when related endoscopies are performed together. The same-day preoperative and postoperative care is included in this code's 0-day global period.

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

Show the CMS file lines behind this rate
RVUs for 52315PPRRVU2026_Oct_nonQPP.csv, line 6,135 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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