No office rate
Choose 52354 for biopsy of an upper-tract lesion; choose 52355 when the surgeon performs endoscopic tumor resection.
On this page
CMS RVU26D · Effective 2026-10-01
52355 Tumor resection Medicare reimbursement rates in Maine
Reports endoscopic removal of a tumor in the ureter or renal collecting system using a ureteroscope or pyeloscope. Compare 52355 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 52355 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
$389.26–$395.19
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 52355: Ureteroscopic upper tract tumor resection
Reports endoscopic removal of a tumor in the ureter or renal collecting system using a ureteroscope or pyeloscope.
A urologist advances an endoscope through the bladder into the ureter or renal collecting system and removes a tumor endoscopically. The procedure is generally performed in an operating room or other procedural setting. It is distinct from inspecting the upper tract or taking a limited tissue sample: the operative work includes tumor resection. The specimen is typically sent for pathologic examination.
Select this service when the operative report supports endoscopic tumor removal in the ureter or renal collecting system; document the site and resection performed. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. For a bilateral procedure, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 52355
- 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 RVU8.78 · 72%
- Practice expense (office) RVU2.36 · 19%
- Malpractice RVU1.13 · 9%
703
Medicare services in 2024 · #3256 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.
52355 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
52351 describes diagnostic inspection of the ureter or renal collecting system. It does not represent the tumor removal reported with 52355.
No office rate
52234 concerns endoscopic treatment of a bladder tumor. Use 52355 for a tumor resected in the ureter or renal collecting system.
No office rate
52353 is for ureteroscopic or pyeloscopic stone fragmentation, not tumor resection. The operative target and treatment determine which code applies.
Compare 52355 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
$389.26
Southern Maine →
Office / nonfacility
Unavailable
Facility
$395.19
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52355 billing questions
When should this be reported instead of 52354?
Use 52355 when the surgeon removes the tumor endoscopically. Code 52354 describes ureteroscopic or pyeloscopic biopsy when tissue is sampled rather than resected.
How does this differ from 52351?
52351 is for diagnostic ureteroscopic or pyeloscopic examination. Report 52355 when the procedure includes resection of a tumor in the ureter or renal collecting system.
Does the code cover a bladder tumor resection?
No. This service is for tumor resection in the ureter or renal collecting system. A bladder tumor procedure is coded according to the bladder service performed.
What happens when related endoscopies are performed in the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together. The operative report should identify each service and the work performed.
How is a bilateral procedure handled?
For a bilateral procedure, modifier 50 is paid at 150% under the CMS rule supplied for this code.
Can an assistant or co-surgeon be paid for this procedure?
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.
6,15152352,,Cystouretero w/stone remove,A,,6.58,1.90,NA,1.90,,0.85,9.33,9.33,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52351,33.4009,09,0,99,0.00,0.00,0.00
6,15252353,,Cystouretero w/lithotripsy,A,,7.31,2.05,NA,2.05,,0.93,10.29,10.29,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52351,33.4009,09,0,99,0.00,0.00,0.00
6,15352354,,Cystouretero w/biopsy,A,,7.80,2.15,NA,2.15,,1.02,10.97,10.97,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52351,33.4009,09,0,99,0.00,0.00,0.00
6,15452355,,Cystouretero w/excise tumor,A,,8.78,2.36,NA,2.36,,1.13,12.27,12.27,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52351,33.4009,09,0,99,0.00,0.00,0.00
6,15552356,,Cysto/uretero w/lithotripsy,A,,7.80,2.11,NA,2.11,,1.02,10.93,10.93,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52351,33.4009,09,0,99,0.00,0.00,0.00
6,15652400,,Cysto cgen post urtl valves,A,,8.47,3.26,NA,3.26,,1.09,12.82,12.82,0,090,0.08,0.83,0.09,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,15752402,,Cysto trurl rescj ejacul dux,A,,5.14,1.12,NA,1.12,,0.65,6.91,6.91,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00