CPT code 52318: Bladder stone removal, large or complicated stone2026 Medicare rate & RVUs in Connecticut

Endoscopic fragmentation and evacuation of a large or complicated bladder stone, reported when treatment exceeds simple removal of a small calculus.

CMS RVU26DEffective Oct 1, 2026One payment locality11.2K Medicare services in 2024

In Connecticut, Medicare pays $434.18 for 52318 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$434.18Hospital or facility

Check a contract rate as a % of Medicare · 52318 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 52318 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 52318 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 52318 covers

During this urologic procedure, the physician passes a cystoscope through the urethra into the bladder, fragments a bladder calculus, and evacuates the pieces. It is used for a large stone (>2.5 cm) or when treatment is complicated. A urologist typically performs it in a hospital outpatient department or ambulatory surgery center, with selected cases in an office setting.

Choose this level from the operative report: document the bladder location, stone size when measured, method of fragmentation and removal, and what made treatment complicated when size alone does not support the level. The related simple or small-stone service is 52317. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies occur in the same session, endoscopy-family pricing applies. Modifier 50 is inappropriate; assistant-at-surgery payment is barred, and co-surgeons and team surgery 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 Connecticut compares for 52318

Across 109 of 109 payment localities, the facility rate for 52318 runs from $384.15 in Wisconsin to $551.22 in Alaska. Connecticut pays $434.18. The RVUs are the same everywhere; the geographic indexes change the dollars.

52318 in Connecticut vs other payment areas
  1. Connecticut · this page$434.18
  2. Los Angeles, CA · California$427.41−$6.77
  3. Washington, DC area · District of Columbia$448.31+$14.13
  4. Miami, FL · Florida$476.55+$42.37
  5. Chicago, IL · Illinois$466.82+$32.64
  6. Manhattan, NY · New York$468.40+$34.22
  7. Alaska · Alaska$551.22+$117.04

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

Every other payment area

52318 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$387.79
ArkansasArkansas—$384.59
ArizonaArizona—$406.22
Bakersfield, CACalifornia—$412.04
Chico, CACalifornia—$408.62
El Centro, CACalifornia—$408.81
Fresno, CACalifornia—$408.62
Hanford, CACalifornia—$408.62

52318 rates by state

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

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Local rates. Clear comparisons.

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

View every state and territory as a table
52318 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 52318 in every payment locality

How the 52318 rate is calculated

Each of 52318’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 · 52318

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.95

8.95 RVUs× 1.000 GPCI

Practice expense2.29

2.29 RVUs× 1.000 GPCI

Malpractice1.16

1.16 RVUs× 1.000 GPCI

Adjusted RVUs

12.4000

Conversion factor

$33.4009

Medicare rate

$414.17

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,137

Code
52318
Physician work
8.95
Practice expense
2.29
Malpractice
1.16

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Facility calculation for 52318 in Connecticut
ComponentRVULocality factorAdjusted
Physician work8.95× 1.0209.1290
Practice expense2.29× 1.0772.4663
Malpractice1.16× 1.2101.4036
Total RVUs12.9989
Conversion factor× 33.4009

Facility rate, Connecticut$434.18

Facility: (8.95 × 1.02 + 2.29 × 1.077 + 1.16 × 1.21) × $33.4009 = $434.18

Open 52318 in the RVU calculator

Payment rules and modifiers for 52318

The CMS indicators that decide how 52318 is paid alongside other services.

CMS payment indicators · 52318

Bladder stone removal, large or complicated stone

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

52318 without 51 · national facility

$414.17

Bladder stone removal, large or complicated stone

52318-51 · Second procedure: 50%

$207.09

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 52318 has changed in Connecticut

52318 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$434.18RVU26D
2026-07-01Not available in this setting$434.18RVU26C
2026-04-01Not available in this setting$434.18RVU26B
2026-01-01Not available in this setting$434.18RVU26A
2025-10-01Not available in this setting$478.48RVU25D
2025-07-01Not available in this setting$478.48RVU25C
2025-04-01Not available in this setting$478.48RVU25B
2025-01-01Not available in this setting$478.48RVU25A
2024-10-01Not available in this setting$489.57RVU24D
2024-07-01Not available in this setting$489.57RVU24C
2024-04-01Not available in this setting$489.57RVU24B
2024-03-09Not available in this setting$489.57RVU24AR
2024-01-01Not available in this setting$481.58RVU24A
2023-10-01Not available in this setting$491.75RVU23D
2023-07-01Not available in this setting$491.75RVU23C
2023-04-01Not available in this setting$491.75RVU23B
2023-01-01Not available in this setting$491.75RVU23A
2022-10-01Not available in this setting$497.29RVU22D
2022-07-01Not available in this setting$497.29RVU22C
2022-04-01Not available in this setting$497.29RVU22B
2022-01-01Not available in this setting$497.29RVU22A
2021-10-01Not available in this setting$501.92RVU21D
2021-07-01Not available in this setting$501.92RVU21C
2021-04-01Not available in this setting$501.92RVU21B
2021-01-01Not available in this setting$501.92RVU21A
2020-10-01Not available in this setting$520.14RVU20D
2020-07-01Not available in this setting$520.14RVU20C
2020-04-01Not available in this setting$520.14RVU20B
2020-01-01Not available in this setting$520.14RVU20A
2019-10-01Not available in this setting$524.59RVU19D
2019-07-01Not available in this setting$524.59RVU19C
2019-04-01Not available in this setting$524.59RVU19B
2019-01-01Not available in this setting$524.59RVU19A
2018-10-01Not available in this setting$525.56RVU18D
2018-07-01Not available in this setting$525.56RVU18C
2018-04-01Not available in this setting$525.56RVU18B
2018-01-01Not available in this setting$525.56RVU18AR1
2017-10-01Not available in this setting$523.24RVU17D
2017-07-01Not available in this setting$523.24RVU17C
2017-04-01Not available in this setting$523.24RVU17B
2017-01-01Not available in this setting$523.24RVU17A
2016-10-01Not available in this setting$520.48RVU16D
2016-07-01Not available in this setting$520.48RVU16C
2016-04-01Not available in this setting$520.48RVU16B
2016-01-01Not available in this setting$520.48RVU16A
2015-10-01Not available in this setting$521.55RVU15D
2015-07-01Not available in this setting$521.55RVU15C
2015-04-01Not available in this setting$518.95RVU15B
2015-01-01Not available in this setting$518.95RVU15A
2014-10-01Not available in this setting$511.40RVU14D
2014-07-01Not available in this setting$511.40RVU14C
2014-04-01Not available in this setting$511.40RVU14B
2014-01-01Not available in this setting$511.40RVU14A
2013-10-01Not available in this setting$492.00RVU13D
2013-07-01Not available in this setting$492.00RVU13C
2013-04-01Not available in this setting$492.00RVU13B
2013-01-01Not available in this setting$492.00RVU13AR

Price 52318 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

52318 billing questions

How does 52318 differ from 52317?

52318 is for complicated treatment or a large bladder stone (>2.5 cm). 52317 is for simple treatment of a small stone (<2.5 cm).

Is stone size alone enough to support 52318?

A stone larger than 2.5 cm supports the large-stone level. For a smaller stone, the operative report should explain why treatment was complicated.

Can the cystoscopy be billed separately?

The cystoscopic access is part of the stone-treatment service; do not report a separate diagnostic cystoscopy for that same work.

Should modifier 50 be appended for multiple bladder stones?

No. CMS identifies bilateral adjustment as inapplicable for this service, and modifier 50 is inappropriate.

How is 52318 handled with another endoscopic procedure in the same session?

When related endoscopies are performed together, CMS applies endoscopy-family pricing. Same-day preoperative and postoperative care is included in the 0-day global period.

Can an assistant or co-surgeon be billed?

CMS does not pay an assistant at surgery for this service and does not permit co-surgeons or team surgery.

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 52318PPRRVU2026_Oct_nonQPP.csv, line 6,137 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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