FeeBase
Log inGet started
Menu

Billing code 52318: Bladder stone removalMedicare rate & RVUs

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, 2026109 payment localities11.2K Medicare services in 2024

Medicare pays $414.17 for 52318 nationally in a facility.

Medicare rate · 52318

Bladder stone removal

Swap in your local Medicare rate.

Work RVUs
8.95
Total RVUs
12.40
Global days
000

National rate · 2026

$414.17

Facility setting, before claim adjustments.

See every locality for 52318 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 52318 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. 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.

Where 52318 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

52318 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$387.79
Alaska*Unavailable$551.22
ArizonaUnavailable$406.22
ArkansasUnavailable$384.59
AtlantaUnavailable$424.08
AustinUnavailable$414.79
BakersfieldUnavailable$412.04
Baltimore/Surr. CntysUnavailable$433.72
BeaumontUnavailable$404.54
BrazoriaUnavailable$407.35

52318 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
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

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

Swap in your local Medicare rate.

Work 8.95Practice expense 2.29Malpractice 1.16

12.4000 adjusted RVUs×$33.4009 conversion factor=$414.17

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

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

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

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

52318 compared with similar codes

Compare codes

52318 vs 52317 vs 52320 vs 52352: national Medicare rates

Swap in your local Medicare rate.

  • 52318
    Bladder stone removal · 8.95 wRVU
    —
  • 52317
    Bladder stone removal · 6.54 wRVU
    $868.42
  • 52320
    Ureteral stone removal · 4.57 wRVU
    —
  • 52352
    Ureteroscopy · 6.58 wRVU
    —

How to choose

52317Bladder stone removal
Use 52317 for simple treatment of a small bladder stone (<2.5 cm). Use 52318 for complicated treatment or a large stone (>2.5 cm).
52320Ureteral stone removal
52320 treats a ureteral calculus through cystoscopic access. For a calculus in the bladder treated by fragmentation and evacuation, consider 52318 when the treatment is complicated or the stone is large.
52352Ureteroscopy
52352 involves ureteroscopy or pyeloscopy to remove or manipulate a calculus in the upper urinary tract. 52318 is for a bladder calculus treated endoscopically.

Codes related to 52318

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 52318
CodeHow it relatesNational office range
Same family
52317Bladder stone removalThe simple or small-bladder-stone level in the same litholapaxy family.$767.01–$1,154.02
Used instead
52320Ureteral stone removalCystoscopic calculus removal applies to a ureteral stone rather than a bladder stone.No office rate
52352UreteroscopyUreteroscopy or pyeloscopy with calculus removal addresses an upper urinary tract stone.No office rate

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)

Open CMS sourceHow we calculate rates

Did this answer your question about what 52318 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 52318 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →