$201.96
Choose 52000 for bladder cystoscopy alone. Choose 52351 when the diagnostic endoscopic examination extends into the ureter or kidney collecting system.
On this page
CMS RVU26D · Effective 2026-10-01
52351 Ureteroscopy Medicare reimbursement rates in Ohio
Reports endoscopic diagnostic inspection of the ureter or kidney collecting system when the upper urinary tract is examined without therapeutic treatment. Compare 52351 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 52351 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
$261.91
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.
Urology
About 52351: Diagnostic ureteroscopy or pyeloscopy
Reports endoscopic diagnostic inspection of the ureter or kidney collecting system when the upper urinary tract is examined without therapeutic treatment.
A urologist advances an endoscope through the bladder into the ureter and, when needed, the kidney’s collecting system to inspect the upper urinary tract. The examination may be part of evaluating hematuria, an imaging abnormality, suspected obstruction, or a possible upper-tract lesion. It is performed in an office or procedural setting appropriate to the patient and planned examination.
Report 52351 when the ureter or collecting system is examined for diagnostic purposes and no separately coded therapeutic intervention defines the service. The operative note should identify the indication, side and anatomic area examined, scope findings, and any treatment performed. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 52351
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU5.61 · 70%
- Practice expense (office) RVU1.66 · 21%
- Malpractice RVU0.71 · 9%
23.7K
Medicare services in 2024 · #1070 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.
52351 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
52351 is for diagnostic inspection; 52352 describes ureteroscopic stone removal.
No office rate
52351 describes diagnostic inspection, while 52353 is used when ureteroscopic lithotripsy treats a stone.
No office rate
Use 52354 when the ureteroscopic service includes biopsy; 52351 is for diagnostic inspection without biopsy.
Compare 52351 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
Ohio →
Office / nonfacility
Unavailable
Facility
$261.91
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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 52351 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
6,150
- Code
- 52351
- Physician work
- 5.61
- Practice expense
- 1.66
- Malpractice
- 0.71
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.61 | × 1.000 | 5.6100 |
| Practice expense | 1.66 | × 0.913 | 1.5156 |
| Malpractice | 0.71 | × 1.008 | 0.7157 |
| Total RVUs | 7.8413 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$261.91
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.61 | 1 |
| Practice expense | 1.66 | 0.913 |
| Malpractice | 0.71 | 1.008 |
(5.61 × 1 + 1.66 × 0.913 + 0.71 × 1.008) × $33.4009 = $261.91
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.
52351 billing questions
When should 52351 be used instead of a therapeutic ureteroscopy code?
Use 52351 for diagnostic inspection without a therapeutic intervention. If the session includes stone treatment, biopsy, or tumor excision, select the code describing that intervention rather than reporting diagnostic inspection as a separate service.
How does 52351 differ from 52000?
Code 52000 describes cystoscopy of the bladder. Code 52351 applies when the endoscopic examination extends into the ureter or kidney collecting system.
Can 52351 be reported with a stone-treatment code?
When ureteroscopy is performed to treat a stone, report the applicable therapeutic code, such as 52352 for stone removal or 52353 for lithotripsy. Diagnostic inspection that is part of that treatment is not separately reported.
Can modifier 50 be used for bilateral 52351?
No. CMS identifies bilateral adjustment as inapplicable and modifier 50 as inappropriate for this code.
How does Medicare handle other procedures performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Are assistant or co-surgeon services payable with 52351?
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.
6,14752344,,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
6,15052351,,Cystouretero & or pyeloscope,A,,5.61,1.66,NA,1.66,,0.71,7.98,7.98,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703