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Billing code 52342: UPJ stricture treatmentMedicare rate & RVUs

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

CMS RVU26DEffective Oct 1, 2026109 payment localities123 Medicare services in 2024

Medicare pays $272.22 for 52342 nationally in a facility.

Medicare rate · 52342

UPJ stricture treatment

Swap in your local Medicare rate.

Work RVUs
5.7
Total RVUs
8.15
Global days
000

National rate · 2026

$272.22

Facility setting, before claim adjustments.

See every locality for 52342 → · 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 52342 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 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

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

109 of 109 payment localities

52342 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$254.45
Alaska*Unavailable$360.20
ArizonaUnavailable$266.93
ArkansasUnavailable$252.29
AtlantaUnavailable$278.61
AustinUnavailable$273.15
BakersfieldUnavailable$271.82
Baltimore/Surr. CntysUnavailable$285.24
BeaumontUnavailable$265.32
BrazoriaUnavailable$267.86

52342 rates by state

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

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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

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

Swap in your local Medicare rate.

Work 5.70Practice expense 1.72Malpractice 0.73

8.1500 adjusted RVUs×$33.4009 conversion factor=$272.22

All indexes start 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

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

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

52342 compared with similar codes

Compare codes

52342 vs 52341 vs 52343 vs 52345 vs 52346: national Medicare rates

Swap in your local Medicare rate.

  • 52342
    UPJ stricture treatment · 5.7 wRVU
    —
  • 52341
    Ureteral stricture treatment · 5.22 wRVU
    —
  • 52343
    Renal stricture treatment · 6.39 wRVU
    —
  • 52345
    UPJ stricture incision · 7.36 wRVU
    —
  • 52346
    Renal stricture treatment · 8.37 wRVU
    —

How to choose

52341Ureteral stricture treatment
Use 52341 when the treated narrowing is in the ureter. Code 52342 identifies treatment at the ureteropelvic junction.
52343Renal stricture treatment
Use 52343 for a renal stricture. Code 52342 is for a stricture at the junction of the renal pelvis and ureter.
52345UPJ stricture incision
Both address a UPJ stricture, but 52345 includes ureteroscopy. Code 52342 is the fit when the documented approach does not include ureteroscopy.
52346Renal stricture treatment
52346 combines ureteroscopy with treatment of a renal stricture. Code 52342 is for UPJ treatment without that renal-stricture service.

Codes related to 52342

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

Codes related to 52342
CodeHow it relatesNational office range
Same family
52341Ureteral stricture treatmentTreats a ureteral stricture rather than a narrowing at the UPJ.No office rate
52343Renal stricture treatmentTreats a renal stricture; the treated site differs from the UPJ.No office rate
52344Stricture treatmentAdds ureteroscopy for treatment of a ureteral stricture.No office rate
52346Renal stricture treatmentAdds ureteroscopy for treatment of a renal stricture.No office rate
Used instead
52345UPJ stricture incisionUPJ stricture treatment with ureteroscopy.No office rate

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)

Open CMS sourceHow we calculate rates

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