Billing code 52315: Cystoscopic removalMedicare rate & RVUs in Delaware
Report complicated cystourethroscopic extraction of a foreign body, calculus, or ureteral stent located in the urethra or bladder.
Medicare pays $452.99 for 52315 in the office in Delaware (Delaware). Which amount applies depends on the service address.
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 9 sections
What 52315 covers
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.
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 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $452.99 | $240.47 |
How the 52315 rate is calculated
Each of 52315’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 · 52315
RVUs × geographic indexes × conversion factor
Work5.07
5.07 RVUs× 1.000 GPCI
Practice expense7.96
7.96 RVUs× 1.000 GPCI
Malpractice0.67
0.67 RVUs× 1.000 GPCI
Adjusted RVUs
13.7000
Conversion factor
$33.4009
Medicare rate
$457.59
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 52315
The CMS indicators that decide how 52315 is paid alongside other services.
CMS payment indicators · 52315
Cystoscopic removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
52315 without 51 · national office
$457.59
Cystoscopic removal
52315-51 · Second procedure: 50%
$228.80
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%).
52315 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 52310Cystoscopic removal
- 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.
- 52317Bladder stone removal
- 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.
- 52318Bladder stone removal
- 52318 is for more extensive bladder stone litholapaxy. It is not the code for complicated removal of a stent or other foreign body.
- 52352Ureteroscopy
- 52352 involves ureteroscopic stone removal. This code is for complicated removal of a foreign body, calculus, or stent located in the urethra or bladder.
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 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
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