$274.77
52310 covers simple cystoscopic removal of a foreign body, calculus, or ureteral stent from the bladder or urethra; it does not treat a ureterocele.
On this page
CMS RVU26D · Effective 2026-10-01
52300 Ureterocele treatment Medicare reimbursement rates in Iowa
Reports cystoscopic incision or resection of a ureterocele, typically to open the ureteral outlet and improve urine drainage. Compare 52300 office and facility rates across CMS payment localities in Iowa.
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 52300 in Iowa?
Iowa 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
No supported rate
Facility setting
$229.42
1 of 1 localities have a supported rate.
Payment area: Iowa
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
About 52300: Endoscopic ureterocele incision or resection
Reports cystoscopic incision or resection of a ureterocele, typically to open the ureteral outlet and improve urine drainage.
A urologist uses a cystoscope to incise or resect a ureterocele, a pouch-like enlargement of the ureter’s opening into the bladder. The endoscopic treatment opens the ureterocele to improve drainage, such as when it contributes to urinary obstruction, hydronephrosis, or recurrent infection. The procedure is commonly performed in a hospital or ambulatory surgery setting; the code includes ureteral catheterization when performed as part of the service.
Report the code when the operative note supports incision or resection of a ureterocele, rather than stone treatment, stricture treatment, or stent work alone. Document the ureterocele’s location, the indication, and the treatment performed. The code has a 0-day global period, so same-day preoperative and postoperative care is included. CMS prices it as bilateral, and modifier 50 does not increase payment. Endoscopy family pricing applies when related endoscopies are performed together. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 52300
- 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
- The code is already priced as bilateral; modifier 50 does not increase payment.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.17 · 70%
- Practice expense (office) RVU1.57 · 21%
- Malpractice RVU0.66 · 9%
171
Medicare services in 2024 · #4473 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.
52300 compared with similar codes
Office rates for Iowa, from the same CMS release.
$342.65
52332 describes placement of an indwelling ureteral stent. Use 52300 for ureterocele incision or resection, not stent placement alone.
No office rate
52341 is directed at endoscopic treatment of a ureteral stricture. Choose 52300 when the treated abnormality is a ureterocele.
No office rate
52320 covers cystoscopic removal of a ureteral calculus. It is not the code for opening or resecting a ureterocele.
Compare 52300 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
Iowa →
Office / nonfacility
Unavailable
Facility
$229.42
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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 52300 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
6,131
- Code
- 52300
- Physician work
- 5.17
- Practice expense
- 1.57
- Malpractice
- 0.66
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.17 | × 1.000 | 5.1700 |
| Practice expense | 1.57 | × 0.915 | 1.4366 |
| Malpractice | 0.66 | × 0.397 | 0.2620 |
| Total RVUs | 6.8686 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$229.42
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.17 | 1 |
| Practice expense | 1.57 | 0.915 |
| Malpractice | 0.66 | 0.397 |
(5.17 × 1 + 1.57 × 0.915 + 0.66 × 0.397) × $33.4009 = $229.42
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.
52300 billing questions
When should this code be chosen over a ureteral stricture code?
Use this code for endoscopic incision or resection of a ureterocele. A ureteral stricture code describes treatment directed at a narrowed ureteral segment.
Is ureteral catheterization included?
Yes. Ureteral catheterization is included in the service when performed as part of the ureterocele procedure.
Can a separately placed ureteral stent be reported?
A temporary catheterization is not the same as placement of an indwelling stent. If a stent is inserted, document that distinct work and review applicable coding edits before reporting an additional code.
Should modifier 50 be appended for treatment on both sides?
CMS prices this code as bilateral, and modifier 50 does not increase payment.
What global-period care is included?
The 0-day global period includes same-day preoperative and postoperative care. Care on later dates is outside that same-day package.
What supports payment for an assistant at surgery?
The record must document medical necessity for the assistant. CMS does not permit co-surgeons or team surgery for this code.
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.
6,12852285,,Cystoscopy and treatment,A,,3.51,5.76,,1.19,,0.49,9.76,5.19,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,12952287,,Cystoscopy chemodenervation,A,,3.12,7.34,,0.91,,0.43,10.89,4.46,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13052290,,Cystoscopy and treatment,A,,4.47,1.41,NA,1.41,,0.57,6.45,6.45,0,000,0.00,0.00,0.00,3,2,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13152300,,Cystoscopy and treatment,A,,5.17,1.57,NA,1.57,,0.66,7.40,7.40,0,000,0.00,0.00,0.00,3,2,0,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13252301,,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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136