FeeBase
Log inGet started
Menu

Billing code 52351: UreteroscopyMedicare rate & RVUs

Reports endoscopic diagnostic inspection of the ureter or kidney collecting system when the upper urinary tract is examined without therapeutic treatment.

CMS RVU26DEffective Oct 1, 2026109 payment localities23.7K Medicare services in 2024

Medicare pays $266.54 for 52351 nationally in a facility.

Medicare rate · 52351

Ureteroscopy

Swap in your local Medicare rate.

Work RVUs
5.61
Total RVUs
7.98
Global days
000

National rate · 2026

$266.54

Facility setting, before claim adjustments.

See every locality for 52351 → · 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 52351 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 52351 covers

A urologist advances an endoscope through the bladder into the ureter and, when needed, the kidney’s collecting system to inspect the upper urinary tract. The examination may be part of evaluating hematuria, an imaging abnormality, suspected obstruction, or a possible upper-tract lesion. It is performed in an office or procedural setting appropriate to the patient and planned examination.

Report 52351 when the ureter or collecting system is examined for diagnostic purposes and no separately coded therapeutic intervention defines the service. The operative note should identify the indication, side and anatomic area examined, scope findings, and any treatment performed. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, 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 52351 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

52351 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$249.32
Alaska*Unavailable$353.18
ArizonaUnavailable$261.41
ArkansasUnavailable$247.22
AtlantaUnavailable$272.76
AustinUnavailable$267.43
BakersfieldUnavailable$266.15
Baltimore/Surr. CntysUnavailable$279.21
BeaumontUnavailable$259.87
BrazoriaUnavailable$262.32

52351 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
52351 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 52351 rate is calculated

Each of 52351’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 · 52351

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.61Practice expense 1.66Malpractice 0.71

7.9800 adjusted RVUs×$33.4009 conversion factor=$266.54

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

Payment rules and modifiers for 52351

The CMS indicators that decide how 52351 is paid alongside other services.

CMS payment indicators · 52351

Ureteroscopy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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

52351 without 51 · national facility

$266.54

Ureteroscopy

52351-51 · Second procedure: 50%

$133.27

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

52351 compared with similar codes

Compare codes

52351 vs 52000 vs 52352 vs 52353 vs 52354: national Medicare rates

Swap in your local Medicare rate.

  • 52351
    Ureteroscopy · 5.61 wRVU
    —
  • 52000
    Cystoscopy · 1.49 wRVU
    $215.77
  • 52352
    Ureteroscopy · 6.58 wRVU
    —
  • 52353
    Stone lithotripsy · 7.31 wRVU
    —
  • 52354
    Upper urinary tract biopsy · 7.8 wRVU
    —

How to choose

52000Cystoscopy
Choose 52000 for bladder cystoscopy alone. Choose 52351 when the diagnostic endoscopic examination extends into the ureter or kidney collecting system.
52352Ureteroscopy
52351 is for diagnostic inspection; 52352 describes ureteroscopic stone removal.
52353Stone lithotripsy
52351 describes diagnostic inspection, while 52353 is used when ureteroscopic lithotripsy treats a stone.
52354Upper urinary tract biopsy
Use 52354 when the ureteroscopic service includes biopsy; 52351 is for diagnostic inspection without biopsy.

Codes related to 52351

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

Codes related to 52351
CodeHow it relatesNational office range
Same family
52352UreteroscopyUreteroscopy with stone removal rather than diagnostic inspection alone.No office rate
52353Stone lithotripsyUreteroscopy with lithotripsy for stone treatment.No office rate
52354Upper urinary tract biopsyUreteroscopy with biopsy of an upper-tract lesion.No office rate
52355Tumor resectionUreteroscopy with excision of an upper-tract tumor.No office rate
Used instead
52000CystoscopyBladder-only cystoscopy when the ureter and kidney collecting system are not examined.$190.07–$288.57

52351 billing questions

When should 52351 be used instead of a therapeutic ureteroscopy code?

Use 52351 for diagnostic inspection without a therapeutic intervention. If the session includes stone treatment, biopsy, or tumor excision, select the code describing that intervention rather than reporting diagnostic inspection as a separate service.

How does 52351 differ from 52000?

Code 52000 describes cystoscopy of the bladder. Code 52351 applies when the endoscopic examination extends into the ureter or kidney collecting system.

Can 52351 be reported with a stone-treatment code?

When ureteroscopy is performed to treat a stone, report the applicable therapeutic code, such as 52352 for stone removal or 52353 for lithotripsy. Diagnostic inspection that is part of that treatment is not separately reported.

Can modifier 50 be used for bilateral 52351?

No. CMS identifies bilateral adjustment as inapplicable and modifier 50 as inappropriate for this code.

How does Medicare handle other procedures performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

Are assistant or co-surgeon services payable with 52351?

Medicare 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 52351PPRRVU2026_Oct_nonQPP.csv, line 6,150 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 52351 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 52351 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 →