CPT code 52342: UPJ stricture treatment, without ureteroscopy2026 Medicare rate & RVUs in New Mexico

Endoscopic treatment of a ureteropelvic junction narrowing is reported when the surgeon treats the stricture through cystoscopic access without ureteroscopy.

CMS RVU26DEffective Oct 1, 2026One payment locality123 Medicare services in 2024

In New Mexico, Medicare pays $272.35 for 52342 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$272.35Hospital or facility

Check a contract rate as a % of Medicare · 52342 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 52342 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 52342 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 52342 covers

A urologist uses cystoscopic access to treat a narrowing at the ureteropelvic junction, where the renal pelvis meets the ureter. Treatment may involve endoscopic incision or dilation of the narrowed area. The procedure is generally performed in an operating room or hospital outpatient setting when a UPJ stricture requires intervention; it is distinct from treatment directed at a ureteral or renal stricture.

Select this code when the treated site is the UPJ and the service does not include the ureteroscopic approach represented by 52345. The operative report should identify the stricture location and describe the treatment 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. For a bilateral procedure, modifier 50 is paid at 150%. CMS 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.

How New Mexico compares for 52342

Across 109 of 109 payment localities, the facility rate for 52342 runs from $252.29 in Arkansas to $360.20 in Alaska. New Mexico pays $272.35. The RVUs are the same everywhere; the geographic indexes change the dollars.

52342 in New Mexico vs other payment areas
  1. New Mexico · this page$272.35
  2. Los Angeles, CA · California$282.34+$9.99
  3. Washington, DC area · District of Columbia$295.48+$23.13
  4. Miami, FL · Florida$311.85+$39.50
  5. Chicago, IL · Illinois$305.41+$33.06
  6. Manhattan, NY · New York$308.00+$35.65
  7. Alaska · Alaska$360.20+$87.85

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

Every other payment area

52342 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$254.45
ArkansasArkansas—$252.29
ArizonaArizona—$266.93
Bakersfield, CACalifornia—$271.82
Chico, CACalifornia—$269.66
El Centro, CACalifornia—$269.78
Fresno, CACalifornia—$269.66
Hanford, CACalifornia—$269.66

52342 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.

View every state and territory as a table
52342 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 52342 in every payment locality

How the 52342 rate is calculated

Each of 52342’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 · 52342

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.70

5.70 RVUs× 1.000 GPCI

Practice expense1.72

1.72 RVUs× 1.000 GPCI

Malpractice0.73

0.73 RVUs× 1.000 GPCI

Adjusted RVUs

8.1500

Conversion factor

$33.4009

Medicare rate

$272.22

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

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,145

Code
52342
Physician work
5.70
Practice expense
1.72
Malpractice
0.73

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Facility calculation for 52342 in New Mexico
ComponentRVULocality factorAdjusted
Physician work5.70× 1.0005.7000
Practice expense1.72× 0.9171.5772
Malpractice0.73× 1.2010.8767
Total RVUs8.1540
Conversion factor× 33.4009

Facility rate, New Mexico$272.35

Facility: (5.7 × 1 + 1.72 × 0.917 + 0.73 × 1.201) × $33.4009 = $272.35

Open 52342 in the RVU calculator

Payment rules and modifiers for 52342

The CMS indicators that decide how 52342 is paid alongside other services.

CMS payment indicators · 52342

UPJ stricture treatment, without ureteroscopy

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 50 · payment effect

With and without the modifier

52342 without 50 · national facility

$272.22

UPJ stricture treatment, without ureteroscopy

52342-50 · Bilateral: 150%

$408.33

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).

When to use modifier 50

How 52342 has changed in New Mexico

52342 · 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$272.35RVU26D
2026-07-01Not available in this setting$272.35RVU26C
2026-04-01Not available in this setting$272.35RVU26B
2026-01-01Not available in this setting$272.35RVU26A
2025-10-01Not available in this setting$292.80RVU25D
2025-07-01Not available in this setting$292.80RVU25C
2025-04-01Not available in this setting$292.80RVU25B
2025-01-01Not available in this setting$292.80RVU25A
2024-10-01Not available in this setting$299.90RVU24D
2024-07-01Not available in this setting$299.90RVU24C
2024-04-01Not available in this setting$299.90RVU24B
2024-03-09Not available in this setting$299.90RVU24AR
2024-01-01Not available in this setting$295.00RVU24A
2023-10-01Not available in this setting$301.07RVU23D
2023-07-01Not available in this setting$301.07RVU23C
2023-04-01Not available in this setting$301.07RVU23B
2023-01-01Not available in this setting$301.07RVU23A
2022-10-01Not available in this setting$305.11RVU22D
2022-07-01Not available in this setting$305.11RVU22C
2022-04-01Not available in this setting$305.11RVU22B
2022-01-01Not available in this setting$305.11RVU22A
2021-10-01Not available in this setting$307.14RVU21D
2021-07-01Not available in this setting$307.14RVU21C
2021-04-01Not available in this setting$307.14RVU21B
2021-01-01Not available in this setting$307.14RVU21A
2020-10-01Not available in this setting$317.76RVU20D
2020-07-01Not available in this setting$317.76RVU20C
2020-04-01Not available in this setting$317.76RVU20B
2020-01-01Not available in this setting$317.76RVU20A
2019-10-01Not available in this setting$320.58RVU19D
2019-07-01Not available in this setting$320.58RVU19C
2019-04-01Not available in this setting$320.58RVU19B
2019-01-01Not available in this setting$320.58RVU19A
2018-10-01Not available in this setting$321.55RVU18D
2018-07-01Not available in this setting$321.55RVU18C
2018-04-01Not available in this setting$321.55RVU18B
2018-01-01Not available in this setting$321.55RVU18AR1
2017-10-01Not available in this setting$319.36RVU17D
2017-07-01Not available in this setting$319.36RVU17C
2017-04-01Not available in this setting$319.36RVU17B
2017-01-01Not available in this setting$319.36RVU17A
2016-10-01Not available in this setting$315.77RVU16D
2016-07-01Not available in this setting$315.77RVU16C
2016-04-01Not available in this setting$315.77RVU16B
2016-01-01Not available in this setting$315.77RVU16A
2015-10-01Not available in this setting$317.00RVU15D
2015-07-01Not available in this setting$317.00RVU15C
2015-04-01Not available in this setting$315.42RVU15B
2015-01-01Not available in this setting$315.42RVU15A
2014-10-01Not available in this setting$309.03RVU14D
2014-07-01Not available in this setting$309.03RVU14C
2014-04-01Not available in this setting$309.03RVU14B
2014-01-01Not available in this setting$309.03RVU14A
2013-10-01Not available in this setting$300.93RVU13D
2013-07-01Not available in this setting$300.93RVU13C
2013-04-01Not available in this setting$300.93RVU13B
2013-01-01Not available in this setting$300.93RVU13AR

Price 52342 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

52342 billing questions

How does this differ from treatment of a ureteral stricture?

This code is for a narrowing at the ureteropelvic junction. Use the corresponding ureteral-stricture code when the treated narrowing is in the ureter rather than at the UPJ.

When is 52345 a better fit?

52345 describes UPJ stricture treatment with ureteroscopy. Choose 52342 when the documented service treats the UPJ stricture without that ureteroscopic approach.

What should the operative report document?

Document the UPJ as the treatment site and describe the intervention, such as incision or dilation. The report should support that the service addressed a stricture rather than a different urinary tract condition.

How are related endoscopies priced together?

CMS applies endoscopy-family pricing when related endoscopies are performed together. Review the procedures performed as a group under that pricing rule.

How is a bilateral procedure reported?

Report modifier 50 for a bilateral procedure; CMS pays it at 150%. The operative documentation should establish treatment on both sides.

Can an assistant or co-surgeon be reported?

CMS 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

Show the CMS file lines behind this rate
RVUs for 52342PPRRVU2026_Oct_nonQPP.csv, line 6,145 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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