No office rate
52352 is for endoscopic stone removal or manipulation without lithotripsy. Choose 52353 when the operative report documents energy-based fragmentation.
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CMS RVU26D · Effective 2026-10-01
52353 Stone lithotripsy Medicare reimbursement rates in Pennsylvania
Report ureteroscopic or pyeloscopic lithotripsy when a urologist uses an endoscope and energy to fragment a ureteral or kidney stone. Compare 52353 office and facility rates across CMS payment localities in Pennsylvania.
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 52353 in Pennsylvania?
Pennsylvania 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
$336.37–$356.89
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
About 52353: Ureteroscopic lithotripsy
Report ureteroscopic or pyeloscopic lithotripsy when a urologist uses an endoscope and energy to fragment a ureteral or kidney stone.
A urologist passes an endoscope through the bladder into the ureter or kidney collecting system and uses laser or another energy source to break a stone into smaller pieces. The procedure is commonly performed in a hospital operating room or ambulatory surgery center for ureteral or renal calculi that require endoscopic fragmentation.
Report this code when the operative record supports both endoscopic access to the ureter or kidney and active stone fragmentation. Distinguish it from endoscopic stone removal without fragmentation and from diagnostic inspection alone. If an indwelling ureteral stent is inserted as part of the lithotripsy, code 52356 describes that combination. Medicare 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 procedures, 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 52353
- 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 RVU7.31 · 71%
- Practice expense (office) RVU2.05 · 20%
- Malpractice RVU0.93 · 9%
11.2K
Medicare services in 2024 · #1416 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.
52353 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
52356 combines ureteroscopic or pyeloscopic lithotripsy with insertion of an indwelling ureteral stent. Use 52353 when that stent insertion is not part of the procedure.
No office rate
52351 describes diagnostic ureteroscopic or pyeloscopic inspection. It does not describe the stone fragmentation reported with 52353.
No office rate
52325 describes ureteral-calculus fragmentation using a different endoscopic approach; 52353 involves ureteroscopy or pyeloscopy with lithotripsy.
Compare 52353 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
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$356.89
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$336.37
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52353 billing questions
When should 52353 be chosen instead of 52352?
Use 52353 when the surgeon fragments a ureteral or renal stone with energy during ureteroscopy or pyeloscopy. Code 52352 describes endoscopic stone removal or manipulation without lithotripsy.
How does 52353 differ from 52356?
52356 describes ureteroscopic or pyeloscopic lithotripsy with insertion of an indwelling ureteral stent. When that stent insertion is part of the lithotripsy procedure, report 52356 rather than separately adding 52332 to 52353.
What documentation supports 52353?
The operative report should identify the treated stone and document endoscopic access to the ureter or kidney, the energy-based fragmentation performed, and the treatment site.
Can modifier 50 be used for bilateral treatment?
CMS lists this as a bilateral procedure; when performed bilaterally and reported with modifier 50, payment is at 150%.
How are related endoscopic procedures paid when performed together?
Medicare applies endoscopy family pricing when related endoscopies are performed together. The procedure also has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant 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.
6,14952346,,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
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