$797.01
52317 is used for bladder calculus treatment by litholapaxy, with the code’s size criterion distinguishing it. Choose 52325 when the documented method is ultrasonic fragmentation under cystourethroscopy.
On this page
CMS RVU26D · Effective 2026-10-01
52325 Stone fragmentation Medicare reimbursement rates in Kentucky
Reports endoscopic ultrasonic fragmentation of a urinary calculus under cystoscopic visualization, typically for a bladder stone when fragmentation is performed rather than simple extraction. Compare 52325 office and facility rates across CMS payment localities in Kentucky.
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 52325 in Kentucky?
Kentucky 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
$273.24
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 52325: Cystoscopic ultrasonic stone fragmentation
Reports endoscopic ultrasonic fragmentation of a urinary calculus under cystoscopic visualization, typically for a bladder stone when fragmentation is performed rather than simple extraction.
An urologist uses a cystoscope to visualize a urinary calculus and fragment it with an ultrasonic lithotripter; a bladder stone is a commonly associated example. The procedure is generally performed in an operating room or hospital outpatient setting. The service includes placement of a temporary ureteral catheter as part of the procedure.
Select this code when the documented approach is ultrasonic fragmentation under cystourethroscopy, rather than simple calculus removal, manipulation alone, or ureteroscopic treatment. The operative report should identify the stone location, endoscopic approach, ultrasonic fragmentation, and catheter placement when performed. 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. A bilateral procedure reported with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 52325
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU6.00 · 71%
- Practice expense (office) RVU1.65 · 20%
- Malpractice RVU0.78 · 9%
52
Medicare services in 2024 · #5334 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.
52325 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
52318 is the larger-calculus litholapaxy code for bladder stones. It is not the choice when the documented service is ultrasonic fragmentation under cystourethroscopy.
No office rate
52320 covers cystoscopic removal of a ureteral calculus. Use 52325 when ultrasonic fragmentation, rather than removal without fragmentation, is documented.
No office rate
52353 describes lithotripsy performed through a ureteroscope. Distinguish it from 52325 by the documented endoscopic approach and treatment method.
Compare 52325 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$273.24
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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 52325 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
6,139
- Code
- 52325
- Physician work
- 6.00
- Practice expense
- 1.65
- Malpractice
- 0.78
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.00 | × 1.000 | 6.0000 |
| Practice expense | 1.65 | × 0.889 | 1.4668 |
| Malpractice | 0.78 | × 0.915 | 0.7137 |
| Total RVUs | 8.1806 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$273.24
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6 | 1 |
| Practice expense | 1.65 | 0.889 |
| Malpractice | 0.78 | 0.915 |
(6 × 1 + 1.65 × 0.889 + 0.78 × 0.915) × $33.4009 = $273.24
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.
52325 billing questions
How does this differ from cystoscopic stone removal without fragmentation?
Use 52325 when the report supports ultrasonic fragmentation under cystourethroscopy. Code 52320 describes cystoscopic removal of a ureteral calculus without this fragmentation method.
Is the temporary ureteral catheter separately reported?
Temporary ureteral catheter placement is included in the service described by 52325; do not report it as a separate service solely for that placement.
How should bilateral treatment be reported?
For a bilateral procedure, report modifier 50. CMS pays the bilateral procedure at 150%.
Does the code have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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.
6,13652317,,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
6,13952325,,Cystoscopy stone removal,A,,6.00,1.65,NA,1.65,,0.78,8.43,8.43,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,14052327,,Cystoscopy inject material,A,,5.05,1.05,NA,1.05,,0.64,6.74,6.74,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,14152330,,Cystoscopy and treatment,A,,4.90,12.15,,1.40,,0.62,17.67,6.92,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,14252332,,Cystoscopy and treatment,A,,2.75,8.05,,1.07,,0.36,11.16,4.18,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631