$849.51–$994.07
Use 52317 for simple treatment of a small bladder stone (<2.5 cm). Use 52318 for complicated treatment or a large stone (>2.5 cm).
On this page
CMS RVU26D · Effective 2026-10-01
52318 Bladder stone removal Medicare reimbursement rates in Virginia
Endoscopic fragmentation and evacuation of a large or complicated bladder stone, reported when treatment exceeds simple removal of a small calculus. Compare 52318 office and facility rates across CMS payment localities in Virginia.
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 52318 in Virginia?
Virginia 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
$401.48–$448.31
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 surgery
About 52318: Complicated or large bladder stone removal
Endoscopic fragmentation and evacuation of a large or complicated bladder stone, reported when treatment exceeds simple removal of a small calculus.
During this urologic procedure, the physician passes a cystoscope through the urethra into the bladder, fragments a bladder calculus, and evacuates the pieces. It is used for a large stone (>2.5 cm) or when treatment is complicated. A urologist typically performs it in a hospital outpatient department or ambulatory surgery center, with selected cases in an office setting.
Choose this level from the operative report: document the bladder location, stone size when measured, method of fragmentation and removal, and what made treatment complicated when size alone does not support the level. The related simple or small-stone service is 52317. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies occur in the same session, endoscopy-family pricing applies. Modifier 50 is inappropriate; assistant-at-surgery payment is barred, and co-surgeons and team surgery are not permitted.
CMS billing rules for 52318
- 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 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 RVU8.95 · 72%
- Practice expense (office) RVU2.29 · 18%
- Malpractice RVU1.16 · 9%
11.2K
Medicare services in 2024 · #1417 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.
52318 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
52320 treats a ureteral calculus through cystoscopic access. For a calculus in the bladder treated by fragmentation and evacuation, consider 52318 when the treatment is complicated or the stone is large.
No office rate
52352 involves ureteroscopy or pyeloscopy to remove or manipulate a calculus in the upper urinary tract. 52318 is for a bladder calculus treated endoscopically.
Compare 52318 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
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$448.31
Virginia →
Office / nonfacility
Unavailable
Facility
$401.48
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52318 billing questions
How does 52318 differ from 52317?
52318 is for complicated treatment or a large bladder stone (>2.5 cm). 52317 is for simple treatment of a small stone (<2.5 cm).
Is stone size alone enough to support 52318?
A stone larger than 2.5 cm supports the large-stone level. For a smaller stone, the operative report should explain why treatment was complicated.
Can the cystoscopy be billed separately?
The cystoscopic access is part of the stone-treatment service; do not report a separate diagnostic cystoscopy for that same work.
Should modifier 50 be appended for multiple bladder stones?
No. CMS identifies bilateral adjustment as inapplicable for this service, and modifier 50 is inappropriate.
How is 52318 handled with another endoscopic procedure in the same session?
When related endoscopies are performed together, CMS applies endoscopy-family pricing. Same-day preoperative and postoperative care is included in the 0-day global period.
Can an assistant or co-surgeon be billed?
CMS does not pay an assistant at surgery for this service and does not permit co-surgeons or team surgery.
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.
6,13452310,,Cystoscopy and treatment,A,,2.74,5.84,,0.93,,0.36,8.94,4.03,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13552315,,Cystoscopy and treatment,A,,5.07,7.96,,1.52,,0.67,13.70,7.26,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13652317,,Remove bladder stone,A,,6.54,18.61,,1.72,,0.85,26.00,9.11,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13752318,,Remove bladder stone,A,,8.95,2.29,NA,2.29,,1.16,12.40,12.40,0,000,0.00,0.00,0.00,3,0,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13852320,,Cystoscopy and treatment,A,,4.57,1.33,NA,1.33,,0.58,6.48,6.48,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,13952325,,Cystoscopy stone removal,A,,6.00,1.65,NA,1.65,,0.78,8.43,8.43,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00
6,14052327,,Cystoscopy inject material,A,,5.05,1.05,NA,1.05,,0.64,6.74,6.74,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00