No office rate
Both codes treat a renal stricture. Choose 52346 when ureteroscopy and/or pyeloscopy is used; 52343 represents treatment without those scopes.
On this page
CMS RVU26D · Effective 2026-10-01
52343 Renal stricture treatment Medicare reimbursement rates in Maine
Endoscopic treatment of a narrowing within the kidney’s collecting system, reported when the procedure is performed through cystourethroscopic access. Compare 52343 office and facility rates across CMS payment localities in Maine.
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 52343 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$287.32–$291.95
2 of 2 localities have a supported rate.
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 endoscopy
About 52343: Endoscopic renal stricture treatment
Endoscopic treatment of a narrowing within the kidney’s collecting system, reported when the procedure is performed through cystourethroscopic access.
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.
CMS billing rules for 52343
- 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 RVU6.39 · 71%
- Practice expense (office) RVU1.85 · 20%
- Malpractice RVU0.82 · 9%
14
Medicare services in 2024 · #6109 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.
52343 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
52342 applies to treatment at the ureteropelvic junction. Use 52343 for a stricture within the kidney’s collecting system.
No office rate
52341 treats a narrowing in the ureter. 52343 is for a renal collecting-system stricture.
Compare 52343 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$287.32
Southern Maine →
Office / nonfacility
Unavailable
Facility
$291.95
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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 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.
6,14352334,,Create passage to kidney,A,,3.29,1.17,NA,1.17,,0.43,4.89,4.89,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,14452341,,Cysto w/ureter stricture tx,A,,5.22,1.62,NA,1.62,,0.66,7.50,7.50,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,14552342,,Cysto w/up stricture tx,A,,5.70,1.72,NA,1.72,,0.73,8.15,8.15,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,14652343,,Cysto w/renal stricture tx,A,,6.39,1.85,NA,1.85,,0.82,9.06,9.06,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,14752344,,Cysto/uretero stricture tx,A,,6.87,1.96,NA,1.96,,0.89,9.72,9.72,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,14852345,,Cysto/uretero w/up stricture,A,,7.36,2.06,NA,2.06,,0.95,10.37,10.37,0,000,0.00,0.00,0.00,3,1,0,0,0,9,52351,33.4009,09,0,99,0.00,0.00,0.00
6,14952346,,Cystouretero w/renal strict,A,,8.37,2.27,NA,2.27,,1.08,11.72,11.72,0,000,0.00,0.00,0.00,3,1,0,0,0,9,52351,33.4009,09,0,99,0.00,0.00,0.00