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

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 North Carolina, Medicare pays $431.70 for 52315 in the office and $231.01 when it’s performed in a hospital or facility.

$431.70Office (non-facility)
$231.01Hospital or facility
−5.7%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 North Carolina
  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 North Carolina 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. North Carolina pays $431.70. The RVUs are the same everywhere; the geographic indexes change the dollars.

52315 in North Carolina vs other payment areas
  1. North Carolina · this page$431.70
  2. Los Angeles, CA · California$505.67+$73.97
  3. Washington, DC area · District of Columbia$516.59+$84.89
  4. Miami, FL · Florida$502.71+$71.01
  5. Chicago, IL · Illinois$489.09+$57.39
  6. Manhattan, NY · New York$524.62+$92.92
  7. Alaska · Alaska$549.50+$117.80

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

52315 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$414.65$226.43
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

52315 rates by state

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

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 North Carolina 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

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 52315 in North Carolina
ComponentRVULocality factorAdjusted
Physician work5.07× 1.0005.0700
Practice expense7.96× 0.9337.4267
Malpractice0.67× 0.6390.4281
Total RVUs12.9248
Conversion factor× 33.4009

Office rate, North Carolina$431.70

Office: (5.07 × 1 + 7.96 × 0.933 + 0.67 × 0.639) × $33.4009 = $431.70

Facility: (5.07 × 1 + 1.52 × 0.933 + 0.67 × 0.639) × $33.4009 = $231.01

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

How 52315 has changed in North Carolina

52315 · Office / nonfacility

$431.70

Effective 2026-10-01

The base rate is $19.91 higher than on 2025-10-01, moving from $411.79 to $431.70 (4.8%).

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

    $411.79changed to$431.70

    • 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
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $441.25changed to$411.79

    • 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

    $434.05changed to$441.25

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $450.21changed to$434.05

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.21 changed to 8.24
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $463.43changed to$450.21

    • 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
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $465.66changed to$463.43

    • 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

    $455.11changed to$465.66

    • 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
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $431.43changed to$455.11

    • 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
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $407.83changed to$431.43

    • 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

    $403.00changed to$407.83

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.02 changed to 6.15
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $400.25changed to$403.00

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.95 changed to 6.02
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $401.70changed to$400.25

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $399.70changed to$401.70

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $392.55changed to$399.70

    • 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
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $386.49changed to$392.55

    • 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
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $386.49

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$431.70$231.01RVU26D
2026-07-01$431.70$231.01RVU26C
2026-04-01$431.70$231.01RVU26B
2026-01-01$431.70$231.01RVU26A
2025-10-01$411.79$250.94RVU25D
2025-07-01$411.79$250.94RVU25C
2025-04-01$411.79$250.94RVU25B
2025-01-01$411.79$250.94RVU25A
2024-10-01$441.25$256.62RVU24D
2024-07-01$441.25$256.62RVU24C
2024-04-01$441.25$256.62RVU24B
2024-03-09$441.25$256.62RVU24AR
2024-01-01$434.05$252.43RVU24A
2023-10-01$450.21$261.10RVU23D
2023-07-01$450.21$261.10RVU23C
2023-04-01$450.21$261.10RVU23B
2023-01-01$450.21$261.10RVU23A
2022-10-01$463.43$265.93RVU22D
2022-07-01$463.43$265.93RVU22C
2022-04-01$463.43$265.93RVU22B
2022-01-01$463.43$265.93RVU22A
2021-10-01$465.66$268.46RVU21D
2021-07-01$465.66$268.46RVU21C
2021-04-01$465.66$268.46RVU21B
2021-01-01$465.66$268.46RVU21A
2020-10-01$455.11$274.88RVU20D
2020-07-01$455.11$274.88RVU20C
2020-04-01$455.11$274.88RVU20B
2020-01-01$455.11$274.88RVU20A
2019-10-01$431.43$274.40RVU19D
2019-07-01$431.43$274.40RVU19C
2019-04-01$431.43$274.40RVU19B
2019-01-01$431.43$274.40RVU19A
2018-10-01$407.83$275.11RVU18D
2018-07-01$407.83$275.11RVU18C
2018-04-01$407.83$275.11RVU18B
2018-01-01$407.83$275.11RVU18AR1
2017-10-01$403.00$274.36RVU17D
2017-07-01$403.00$274.36RVU17C
2017-04-01$403.00$274.36RVU17B
2017-01-01$403.00$274.36RVU17A
2016-10-01$400.25$273.06RVU16D
2016-07-01$400.25$273.06RVU16C
2016-04-01$400.25$273.06RVU16B
2016-01-01$400.25$273.06RVU16A
2015-10-01$401.70$274.04RVU15D
2015-07-01$401.70$274.04RVU15C
2015-04-01$399.70$272.68RVU15B
2015-01-01$399.70$272.68RVU15A
2014-10-01$392.55$269.08RVU14D
2014-07-01$392.55$269.08RVU14C
2014-04-01$392.55$269.08RVU14B
2014-01-01$392.55$269.08RVU14A
2013-10-01$386.49$258.44RVU13D
2013-07-01$386.49$258.44RVU13C
2013-04-01$386.49$258.44RVU13B
2013-01-01$386.49$258.44RVU13AR

Price 52315 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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 North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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