CPT code 52343: Renal stricture treatment2026 Medicare rate & RVUs in Delaware

Endoscopic treatment of a narrowing within the kidney’s collecting system, reported when the procedure is performed through cystourethroscopic access.

CMS RVU26DEffective Oct 1, 20261 payment locality14 Medicare services in 2024

CMS doesn’t publish an office rate for 52343 in Delaware.

—Office (non-facility)
$300.17Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 52343 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Delaware
  2. What 52343 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 52343 covers

This procedure opens a stricture within the kidney’s collecting system using instruments passed through the urethra and bladder. The urologist may dilate or incise the narrowed area, such as when it obstructs urine drainage. The code distinguishes treatment without ureteroscopy or pyeloscopy; when those scopes are used to treat the renal stricture, the corresponding code is 52346. These procedures are generally performed in a facility operating room.

Select the code based on the stricture’s documented anatomic site and the endoscopic approach. The operative report should identify the renal collecting-system narrowing and describe how it was treated, including whether ureteroscopy or pyeloscopy was used. 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. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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.

52343 in Delaware

52343 office and facility rates by payment locality
Payment localityOfficeFacility
DelawareUnavailable$300.17

How the 52343 rate is calculated

Each of 52343’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 · 52343

RVUs × geographic indexes × conversion factor

Work6.39

6.39 RVUs× 1.000 GPCI

Practice expense1.85

1.85 RVUs× 1.000 GPCI

Malpractice0.82

0.82 RVUs× 1.000 GPCI

Adjusted RVUs

9.0600

Conversion factor

$33.4009

Medicare rate

$302.61

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 52343

The CMS indicators that decide how 52343 is paid alongside other services.

CMS payment indicators · 52343

Renal stricture treatment

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

52343 without 50 · national facility

$302.61

Renal stricture treatment

52343-50 · Bilateral: 150%

$453.92

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

52343 compared with similar codes

Compare codes · National

4 codes, side by side

  • 52343

    Renal stricture treatment6.39 wRVU

    Not priced

  • 52346

    Renal stricture treatment8.37 wRVU

    Not priced

  • 52342

    UPJ stricture treatment5.7 wRVU

    Not priced

  • 52341

    Ureteral stricture treatment5.22 wRVU

    Not priced

How to choose

52346Renal stricture treatment
Both codes treat a renal stricture. Choose 52346 when ureteroscopy and/or pyeloscopy is used; 52343 represents treatment without those scopes.
52342UPJ stricture treatment
52342 applies to treatment at the ureteropelvic junction. Use 52343 for a stricture within the kidney’s collecting system.
52341Ureteral stricture treatment
52341 treats a narrowing in the ureter. 52343 is for a renal collecting-system stricture.

52343 billing questions

When should 52346 be reported instead?

Report 52346 when ureteroscopy and/or pyeloscopy is used to treat the renal stricture. Code 52343 represents treatment without that scope-based approach.

How does this differ from 52342?

52343 is for a stricture within the kidney’s collecting system. 52342 identifies treatment at the ureteropelvic junction.

What documentation supports 52343?

The operative report should identify the renal collecting-system stricture, describe the treatment performed, and make clear whether ureteroscopy or pyeloscopy was used.

How is bilateral treatment handled?

CMS lists this as a bilateral procedure: modifier 50 is paid at 150%. The record should support treatment on both sides.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 52343. Co-surgeons and team surgery are not permitted.

How does CMS price related endoscopies performed together?

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

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 52343PPRRVU2026_Oct_nonQPP.csv, line 6,146 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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