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Billing code 52353: Stone lithotripsyMedicare rate & RVUs

Report ureteroscopic or pyeloscopic lithotripsy when a urologist uses an endoscope and energy to fragment a ureteral or kidney stone.

CMS RVU26DEffective Oct 1, 2026109 payment localities11.2K Medicare services in 2024

Medicare pays $343.70 for 52353 nationally in a facility.

Medicare rate · 52353

Stone lithotripsy

Swap in your local Medicare rate.

Work RVUs
7.31
Total RVUs
10.29
Global days
000

National rate · 2026

$343.70

Facility setting, before claim adjustments.

See every locality for 52353 → · 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 52353 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 52353 covers

A urologist passes an endoscope through the bladder into the ureter or kidney collecting system and uses laser or another energy source to break a stone into smaller pieces. The procedure is commonly performed in a hospital operating room or ambulatory surgery center for ureteral or renal calculi that require endoscopic fragmentation.

Report this code when the operative record supports both endoscopic access to the ureter or kidney and active stone fragmentation. Distinguish it from endoscopic stone removal without fragmentation and from diagnostic inspection alone. If an indwelling ureteral stent is inserted as part of the lithotripsy, code 52356 describes that combination. Medicare 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 bilateral procedures, modifier 50 is paid at 150%. Medicare 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 52353 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

52353 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$321.66
Alaska*Unavailable$456.28
ArizonaUnavailable$337.10
ArkansasUnavailable$318.98
AtlantaUnavailable$351.77
AustinUnavailable$344.61
BakersfieldUnavailable$342.76
Baltimore/Surr. CntysUnavailable$359.96
BeaumontUnavailable$335.33
BrazoriaUnavailable$338.20

52353 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
52353 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 52353 rate is calculated

Each of 52353’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 · 52353

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.31Practice expense 2.05Malpractice 0.93

10.2900 adjusted RVUs×$33.4009 conversion factor=$343.70

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

Payment rules and modifiers for 52353

The CMS indicators that decide how 52353 is paid alongside other services.

CMS payment indicators · 52353

Stone lithotripsy

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

52353 without 50 · national facility

$343.70

Stone lithotripsy

52353-50 · Bilateral: 150%

$515.55

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

52353 compared with similar codes

Compare codes

52353 vs 52352 vs 52356 vs 52351 vs 52325: national Medicare rates

Swap in your local Medicare rate.

  • 52353
    Stone lithotripsy · 7.31 wRVU
    —
  • 52352
    Ureteroscopy · 6.58 wRVU
    —
  • 52356
    Ureteroscopic lithotripsy · 7.8 wRVU
    —
  • 52351
    Ureteroscopy · 5.61 wRVU
    —
  • 52325
    Stone fragmentation · 6 wRVU
    —

How to choose

52352Ureteroscopy
52352 is for endoscopic stone removal or manipulation without lithotripsy. Choose 52353 when the operative report documents energy-based fragmentation.
52356Ureteroscopic lithotripsy
52356 combines ureteroscopic or pyeloscopic lithotripsy with insertion of an indwelling ureteral stent. Use 52353 when that stent insertion is not part of the procedure.
52351Ureteroscopy
52351 describes diagnostic ureteroscopic or pyeloscopic inspection. It does not describe the stone fragmentation reported with 52353.
52325Stone fragmentation
52325 describes ureteral-calculus fragmentation using a different endoscopic approach; 52353 involves ureteroscopy or pyeloscopy with lithotripsy.

Codes related to 52353

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

Codes related to 52353
CodeHow it relatesNational office range
Used instead
52352UreteroscopyEndoscopic stone removal or manipulation without energy-based fragmentation.No office rate
52356Ureteroscopic lithotripsyUse for ureteroscopic lithotripsy when an indwelling ureteral stent is inserted.No office rate
52351UreteroscopyEndoscopic ureteral or renal inspection without the lithotripsy treatment described by 52353.No office rate
52325Stone fragmentationA different endoscopic approach to fragmentation of a ureteral calculus.No office rate

52353 billing questions

When should 52353 be chosen instead of 52352?

Use 52353 when the surgeon fragments a ureteral or renal stone with energy during ureteroscopy or pyeloscopy. Code 52352 describes endoscopic stone removal or manipulation without lithotripsy.

How does 52353 differ from 52356?

52356 describes ureteroscopic or pyeloscopic lithotripsy with insertion of an indwelling ureteral stent. When that stent insertion is part of the lithotripsy procedure, report 52356 rather than separately adding 52332 to 52353.

What documentation supports 52353?

The operative report should identify the treated stone and document endoscopic access to the ureter or kidney, the energy-based fragmentation performed, and the treatment site.

Can modifier 50 be used for bilateral treatment?

CMS lists this as a bilateral procedure; when performed bilaterally and reported with modifier 50, payment is at 150%.

How are related endoscopic procedures paid when performed together?

Medicare applies endoscopy family pricing when related endoscopies are performed together. The procedure also has a 0-day global period, which includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be reported?

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 52353PPRRVU2026_Oct_nonQPP.csv, line 6,152 (RVU26D)

Open CMS sourceHow we calculate rates

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