CPT code 52325: Stone fragmentation, ultrasonic lithotripsy2026 Medicare rate & RVUs in New York
Reports endoscopic ultrasonic fragmentation of a urinary calculus under cystoscopic visualization, typically for a bladder stone when fragmentation is performed rather than simple extraction.
CMS doesn’t publish an office rate for 52325 in New York.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 52325 covers
An urologist uses a cystoscope to visualize a urinary calculus and fragment it with an ultrasonic lithotripter; a bladder stone is a commonly associated example. The procedure is generally performed in an operating room or hospital outpatient setting. The service includes placement of a temporary ureteral catheter as part of the procedure.
Select this code when the documented approach is ultrasonic fragmentation under cystourethroscopy, rather than simple calculus removal, manipulation alone, or ureteroscopic treatment. The operative report should identify the stone location, endoscopic approach, ultrasonic fragmentation, and catheter placement when performed. 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. A bilateral procedure reported with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; 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.
Where 52325 pays more and less in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | Unavailable | $318.59 |
| NYC suburbs and Long Island, NY | Unavailable | $327.14 |
| Poughkeepsie and northern NYC suburbs, NY | Unavailable | $301.29 |
| Queens, NY | Unavailable | $315.94 |
| Rest of New York | Unavailable | $271.08 |
How the 52325 rate is calculated
Each of 52325’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 · 52325
RVUs × geographic indexes × conversion factor
Work6.00
6.00 RVUs× 1.000 GPCI
Practice expense1.65
1.65 RVUs× 1.000 GPCI
Malpractice0.78
0.78 RVUs× 1.000 GPCI
Adjusted RVUs
8.4300
Conversion factor
$33.4009
Medicare rate
$281.57
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 52325
The CMS indicators that decide how 52325 is paid alongside other services.
CMS payment indicators · 52325
Stone fragmentation, ultrasonic lithotripsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
52325 without 50 · national facility
$281.57
Stone fragmentation, ultrasonic lithotripsy
52325-50 · Bilateral: 150%
$422.36
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
52325 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 52317Bladder stone removalSmall or simple calculus
- 52317 is used for bladder calculus treatment by litholapaxy, with the code’s size criterion distinguishing it. Choose 52325 when the documented method is ultrasonic fragmentation under cystourethroscopy.
- 52318Bladder stone removalLarge or complicated stone
- 52318 is the larger-calculus litholapaxy code for bladder stones. It is not the choice when the documented service is ultrasonic fragmentation under cystourethroscopy.
- 52320Ureteral stone removalWithout stone fragmentation
- 52320 covers cystoscopic removal of a ureteral calculus. Use 52325 when ultrasonic fragmentation, rather than removal without fragmentation, is documented.
- 52353Stone lithotripsyUreteroscopy or pyeloscopy
- 52353 describes lithotripsy performed through a ureteroscope. Distinguish it from 52325 by the documented endoscopic approach and treatment method.
52325 billing questions
How does this differ from cystoscopic stone removal without fragmentation?
Use 52325 when the report supports ultrasonic fragmentation under cystourethroscopy. Code 52320 describes cystoscopic removal of a ureteral calculus without this fragmentation method.
Is the temporary ureteral catheter separately reported?
Temporary ureteral catheter placement is included in the service described by 52325; do not report it as a separate service solely for that placement.
How should bilateral treatment be reported?
For a bilateral procedure, report modifier 50. CMS pays the bilateral procedure at 150%.
Does the code have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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
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