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CMS RVU26D · Effective 2026-10-01

52320 Ureteral stone removal Medicare reimbursement rates in Ohio

Cystoscopic ureteral stone extraction reports endoscopic removal of a ureteral calculus through cystoscopic access when the stone is retrieved without fragmentation. Compare 52320 office and facility rates across CMS payment localities in Ohio.

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 52320 in Ohio?

Ohio 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

$212.73

1 of 1 localities have a supported rate.

Payment area: Ohio

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.

Find 52320 in your payment locality →

Urology procedure

About 52320: Cystoscopic ureteral stone extraction

Cystoscopic ureteral stone extraction reports endoscopic removal of a ureteral calculus through cystoscopic access when the stone is retrieved without fragmentation.

A urologist uses a cystoscope to access the bladder and ureteral opening, then passes instruments through the scope to retrieve a ureteral calculus. The service includes ureteral catheterization and is generally selected when the stone is removed intact with an extraction instrument, such as a basket, rather than broken apart. It is performed in an operating room or another setting equipped for endoscopic urologic treatment.

The operative note should identify the ureteral stone and document its retrieval, the approach, and whether fragmentation was performed. Report a code for fragmentation when the calculus is broken up, and distinguish this service from removal of a stone located in the bladder. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Endoscopy family pricing applies when related endoscopies are performed together. For bilateral treatment reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.

CMS billing rules for 52320

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 RVU4.57 · 71%
  • Practice expense (office) RVU1.33 · 21%
  • Malpractice RVU0.58 · 9%

528

Medicare services in 2024 · #3508 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.

52320 compared with similar codes

Office rates for Ohio, from the same CMS release.

52325

Stone fragmentation

Ultrasonic lithotripsy

No office rate

52320 is for extraction without fragmentation; 52325 applies when the ureteral calculus is fragmented.

52330

Stone manipulation

Without stone removal

$555.05

52320 includes removal of the ureteral calculus. Choose 52330 when the calculus is manipulated but left in place.

52352

Ureteroscopy

Stone removal or manipulation

No office rate

52352 involves ureteroscopy or pyeloscopy for calculus treatment. This code describes removal through cystoscopic access without that ureteroscopic or pyeloscopic approach.

52310

Cystoscopic removal

Simple urethral or bladder removal

$281.73

52310 concerns removal of a calculus or foreign body from the urethra or bladder; 52320 concerns a calculus in the ureter.

Compare 52320 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

Office and facility base rates · shared scale starting at $0
  • Ohio →

    Office / nonfacility

    Unavailable

    Facility

    $212.73

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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 52320 in Ohio.

PPRRVU2026_Oct_nonQPP.csv

6,138

Code
52320
Physician work
4.57
Practice expense
1.33
Malpractice
0.58

GPCI2026.csv

85

Locality
Ohio
Physician work
1.000
Practice expense
0.913
Malpractice
1.008
Facility calculation for 52320 in Ohio
ComponentRVULocality factorAdjusted
Physician work4.57× 1.0004.5700
Practice expense1.33× 0.9131.2143
Malpractice0.58× 1.0080.5846
Total RVUs6.3689
Conversion factor× 33.4009

Facility rate, Ohio$212.73

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work4.571
Practice expense1.330.913
Malpractice0.581.008

(4.57 × 1 + 1.33 × 0.913 + 0.58 × 1.008) × $33.4009 = $212.73

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.

52320 billing questions

How does this differ from code 52325?

Use 52320 when the ureteral calculus is extracted without fragmentation. Code 52325 describes treatment in which the calculus is fragmented.

Can this code be reported for a bladder stone?

No. This code is for removal of a ureteral calculus. Bladder-stone removal is represented by a different code family.

How does this differ from code 52330?

Code 52320 represents removal of the ureteral calculus. Code 52330 is used for manipulation of a ureteral calculus without removal.

What documentation supports reporting this service?

Document the ureteral stone, the cystoscopic approach, and that the stone was retrieved. The note should make clear whether the stone was extracted intact or fragmented.

How is bilateral treatment reported?

When the procedure is performed bilaterally and reported with modifier 50, CMS pays at 150%.

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.

RVUs for 52320PPRRVU2026_Oct_nonQPP.csv, line 6,138 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)