CPT code 52342: UPJ stricture treatment, without ureteroscopy2026 Medicare rate & RVUs in Texas
Endoscopic treatment of a ureteropelvic junction narrowing is reported when the surgeon treats the stricture through cystoscopic access without ureteroscopy.
CMS doesn’t publish an office rate for 52342 in Texas.
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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On this page 9 sections
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.
Where 52342 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $273.15 |
| Beaumont, TX | Unavailable | $265.32 |
| Brazoria, TX | Unavailable | $267.86 |
| Dallas, TX | Unavailable | $270.24 |
| Fort Worth, TX | Unavailable | $269.98 |
| Galveston, TX | Unavailable | $269.14 |
| Houston, TX | Unavailable | $282.51 |
| Rest of Texas | Unavailable | $266.92 |
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
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.
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
| 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
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).
52342 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 52341Ureteral stricture treatmentCystoscopic approach
- Use 52341 when the treated narrowing is in the ureter. Code 52342 identifies treatment at the ureteropelvic junction.
- 52343Renal stricture treatmentWithout ureteroscopy or pyeloscopy
- Use 52343 for a renal stricture. Code 52342 is for a stricture at the junction of the renal pelvis and ureter.
- 52345UPJ stricture incisionUreteropelvic junction
- Both address a UPJ stricture, but 52345 includes ureteroscopy. Code 52342 is the fit when the documented approach does not include ureteroscopy.
- 52346Renal stricture treatmentWith ureteroscopy or pyeloscopy
- 52346 combines ureteroscopy with treatment of a renal stricture. Code 52342 is for UPJ treatment without that renal-stricture service.
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
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