$317.98
Both cover cystoscopic removal from the urethra or bladder, but 52315 is for complicated extraction. Select based on the documented procedural complexity, not just the diagnosis.
On this page
CMS RVU26D · Effective 2026-10-01
52315 Cystoscopic removal Medicare reimbursement rates in Connecticut
Report complicated cystourethroscopic extraction of a foreign body, calculus, or ureteral stent located in the urethra or bladder. Compare 52315 office and facility rates across CMS payment localities in Connecticut.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 52315 in Connecticut?
Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$486.15
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
$254.49
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Urology procedure
About 52315: Complicated cystoscopic foreign body removal
Report complicated cystourethroscopic extraction of a foreign body, calculus, or ureteral stent located in the urethra or bladder.
A urologist uses a cystoscope passed through the urethra to remove a foreign body, calculus, or ureteral stent from the urethra or bladder. The complicated service may involve difficult retrieval, such as extracting an encrusted stent or an object that cannot be removed with straightforward grasping. It is performed in settings such as an office procedure room or a hospital or ambulatory surgery facility, depending on the patient and procedure.
Choose this code rather than the simpler removal code when the operative note supports a complicated extraction; the diagnosis alone does not establish the level. Document the object or stent location, the removal technique, and the circumstances that made retrieval complicated. 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. Modifier 50 is inappropriate. Medicare does not pay for an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 52315
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.07 · 37%
- Practice expense (office) RVU7.96 · 58%
- Malpractice RVU0.67 · 5%
4.8K
Medicare services in 2024 · #1902 by national volume
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.
52315 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$926.62
52317 describes bladder stone treatment by litholapaxy. Use 52315 for complicated extraction of a calculus from the urethra or bladder when the service is not litholapaxy.
No office rate
52318 is for more extensive bladder stone litholapaxy. It is not the code for complicated removal of a stent or other foreign body.
No office rate
52352 involves ureteroscopic stone removal. This code is for complicated removal of a foreign body, calculus, or stent located in the urethra or bladder.
Compare 52315 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Connecticut →
Office / nonfacility
$486.15
Facility
$254.49
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 52315 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
6,135
- Code
- 52315
- Physician work
- 5.07
- Practice expense
- 7.96
- Malpractice
- 0.67
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.07 | × 1.020 | 5.1714 |
| Practice expense | 7.96 | × 1.077 | 8.5729 |
| Malpractice | 0.67 | × 1.210 | 0.8107 |
| Total RVUs | 14.5550 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$486.15
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.07 | 1.02 |
| Practice expense | 7.96 | 1.077 |
| Malpractice | 0.67 | 1.21 |
(5.07 × 1.02 + 7.96 × 1.077 + 0.67 × 1.21) × $33.4009 = $486.15
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.07 | 1.02 |
| Practice expense | 1.52 | 1.077 |
| Malpractice | 0.67 | 1.21 |
(5.07 × 1.02 + 1.52 × 1.077 + 0.67 × 1.21) × $33.4009 = $254.49
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
52315 billing questions
How does this differ from 52310?
52315 is for complicated removal of a foreign body, calculus, or ureteral stent from the urethra or bladder. Use 52310 for the corresponding simpler removal when the documented work supports that level.
Does an encrusted stent automatically qualify as complicated?
No. The operative documentation should describe the extraction difficulty and work performed; the presence of an encrusted stent by itself does not establish the code level.
Can this code be used for a ureteral stone removed with a ureteroscope?
No. This code concerns removal from the urethra or bladder. Ureteroscopic stone extraction is represented by a different procedure code, such as 52352, when its service is performed.
Should modifier 50 be appended for bilateral work?
No. Modifier 50 is inappropriate for this service.
How are related endoscopies priced when performed together?
CMS applies endoscopy family pricing when related endoscopies are performed together. The same-day preoperative and postoperative care is included in this code's 0-day global period.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
6,13252301,,Cystoscopy and treatment,A,,5.36,1.60,NA,1.60,,0.68,7.64,7.64,0,000,0.00,0.00,0.00,3,2,0,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13352305,,Cystoscopy and treatment,A,,5.17,1.50,NA,1.50,,0.66,7.33,7.33,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13452310,,Cystoscopy and treatment,A,,2.74,5.84,,0.93,,0.36,8.94,4.03,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13552315,,Cystoscopy and treatment,A,,5.07,7.96,,1.52,,0.67,13.70,7.26,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13652317,,Remove bladder stone,A,,6.54,18.61,,1.72,,0.85,26.00,9.11,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13752318,,Remove bladder stone,A,,8.95,2.29,NA,2.29,,1.16,12.40,12.40,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13852320,,Cystoscopy and treatment,A,,4.57,1.33,NA,1.33,,0.58,6.48,6.48,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808