CPT code 52356: Ureteroscopic lithotripsy, with ureteral stent2026 Medicare rate & RVUs in Maine
Reports ureteroscopic or pyeloscopic fragmentation of a ureteral or kidney stone when an indwelling ureteral stent is also inserted during the procedure.
CMS doesn’t publish an office rate for 52356 in Maine.
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 52356 covers
A urologist advances an endoscope through the bladder into the ureter and, when needed, the kidney to locate and fragment a stone. The procedure is used for ureteral or renal calculi treated endoscopically, commonly in an operating room or ambulatory surgery setting. An indwelling ureteral stent is inserted during the same procedure to support drainage after treatment.
Report this code when the documented service includes both lithotripsy and stent insertion; the stent placement is included, rather than separately reported as a second procedure. The operative note should identify the treated side and stone location, document fragmentation, and confirm stent placement. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery services are not paid, 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.
Where 52356 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | Unavailable | $346.56 |
| Southern Maine, ME | Unavailable | $351.87 |
How the 52356 rate is calculated
Each of 52356’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 · 52356
RVUs × geographic indexes × conversion factor
Work7.80
7.80 RVUs× 1.000 GPCI
Practice expense2.11
2.11 RVUs× 1.000 GPCI
Malpractice1.02
1.02 RVUs× 1.000 GPCI
Adjusted RVUs
10.9300
Conversion factor
$33.4009
Medicare rate
$365.07
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 52356
The CMS indicators that decide how 52356 is paid alongside other services.
CMS payment indicators · 52356
Ureteroscopic lithotripsy, with ureteral stent
| 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
52356 without 50 · national facility
$365.07
Ureteroscopic lithotripsy, with ureteral stent
52356-50 · Bilateral: 150%
$547.61
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).
52356 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 52353Stone lithotripsyUreteroscopy or pyeloscopy
- Both describe endoscopic lithotripsy of a ureteral or renal stone. 52356 includes insertion of an indwelling ureteral stent; 52353 does not.
- 52352UreteroscopyStone removal or manipulation
- 52352 represents ureteroscopic stone removal without lithotripsy. Choose 52356 when fragmentation and stent insertion are performed.
- 52332Ureteral stentIndwelling stent placement
- 52332 describes ureteral stent insertion without the lithotripsy service. Stent insertion performed as part of 52356 is included in that code.
- 52351UreteroscopyDiagnostic examination only
- 52351 is diagnostic ureteroscopy or pyeloscopy. It does not represent stone fragmentation with stent insertion.
52356 billing questions
How is this different from 52353?
Both include ureteroscopic or pyeloscopic lithotripsy. Use 52356 when an indwelling ureteral stent is also inserted during the procedure; 52353 is the lithotripsy code without that included stent placement.
Can 52332 be reported separately for the stent?
No. Stent insertion is included in 52356 when performed as part of the lithotripsy procedure.
When does 52352 fit instead?
52352 is for ureteroscopic stone removal without lithotripsy. Use 52356 when the stone is fragmented and a stent is inserted.
How should bilateral treatment be reported?
For a bilateral procedure, report modifier 50; CMS pays 150%.
What should the operative note support?
Document the treated side and stone location, that lithotripsy was performed, and that an indwelling ureteral stent was inserted.
How does CMS price related endoscopies performed together?
CMS applies endoscopy-family pricing when related endoscopies are performed together. The payment reflects that family pricing rule.
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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