FeeBase
Log inGet started
Menu

Billing code 52356: Ureteroscopic lithotripsyMedicare rate & RVUs

Reports ureteroscopic or pyeloscopic fragmentation of a ureteral or kidney stone when an indwelling ureteral stent is also inserted during the procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities98.2K Medicare services in 2024

Medicare pays $365.07 for 52356 nationally in a facility.

Medicare rate · 52356

Ureteroscopic lithotripsy

Swap in your local Medicare rate.

Work RVUs
7.8
Total RVUs
10.93
Global days
000

National rate · 2026

$365.07

Facility setting, before claim adjustments.

See every locality for 52356 → · 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 52356 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 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

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

109 of 109 payment localities

52356 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$341.48
Alaska*Unavailable$484.62
ArizonaUnavailable$357.98
ArkansasUnavailable$338.61
AtlantaUnavailable$373.83
AustinUnavailable$365.80
BakersfieldUnavailable$363.47
Baltimore/Surr. CntysUnavailable$382.46
BeaumontUnavailable$356.31
BrazoriaUnavailable$359.03

52356 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
52356 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 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

Swap in your local Medicare rate.

Work 7.80Practice expense 2.11Malpractice 1.02

10.9300 adjusted RVUs×$33.4009 conversion factor=$365.07

All indexes start 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

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

52356 without 50 · national facility

$365.07

Ureteroscopic lithotripsy

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).

When to use modifier 50

52356 compared with similar codes

Compare codes

52356 vs 52353 vs 52352 vs 52332 vs 52351: national Medicare rates

Swap in your local Medicare rate.

  • 52356
    Ureteroscopic lithotripsy · 7.8 wRVU
    —
  • 52353
    Stone lithotripsy · 7.31 wRVU
    —
  • 52352
    Ureteroscopy · 6.58 wRVU
    —
  • 52332
    Ureteral stent · 2.75 wRVU
    $372.75
  • 52351
    Ureteroscopy · 5.61 wRVU
    —

How to choose

52353Stone lithotripsy
Both describe endoscopic lithotripsy of a ureteral or renal stone. 52356 includes insertion of an indwelling ureteral stent; 52353 does not.
52352Ureteroscopy
52352 represents ureteroscopic stone removal without lithotripsy. Choose 52356 when fragmentation and stent insertion are performed.
52332Ureteral stent
52332 describes ureteral stent insertion without the lithotripsy service. Stent insertion performed as part of 52356 is included in that code.
52351Ureteroscopy
52351 is diagnostic ureteroscopy or pyeloscopy. It does not represent stone fragmentation with stent insertion.

Codes related to 52356

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

Codes related to 52356
CodeHow it relatesNational office range
Same family
52353Stone lithotripsyUreteroscopic or pyeloscopic lithotripsy without the stent placement included in 52356.No office rate
Used instead
52352UreteroscopyUreteroscopic stone removal without lithotripsy.No office rate
52332Ureteral stentIndwelling ureteral stent insertion when the service is stenting rather than lithotripsy with stenting.$329.01–$496.12
52351UreteroscopyDiagnostic ureteroscopy or pyeloscopy without the lithotripsy and stent service represented by 52356.No office rate

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% under the supplied bilateral rule.

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

Show the CMS file lines behind this rate
RVUs for 52356PPRRVU2026_Oct_nonQPP.csv, line 6,155 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 52356 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 52356 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 →