No office rate
52320 is for extraction without fragmentation; 52325 applies when the ureteral calculus is fragmented.
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CMS RVU26D · Effective 2026-10-01
52320 Ureteral stone removal Medicare reimbursement rates in Virginia
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 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 52320 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
$209.99–$234.78
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 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 Virginia, from the same CMS release.
$577.21–$673.61
52320 includes removal of the ureteral calculus. Choose 52330 when the calculus is manipulated but left in place.
No office rate
52352 involves ureteroscopy or pyeloscopy for calculus treatment. This code describes removal through cystoscopic access without that ureteroscopic or pyeloscopic approach.
$291.75–$339.63
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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$234.78
Virginia →
Office / nonfacility
Unavailable
Facility
$209.99
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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.
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
6,14152330,,Cystoscopy and treatment,A,,4.90,12.15,,1.40,,0.62,17.67,6.92,0,000,0.00,0.00,0.00,3,1,1,0,0,9,52000,33.4009,09,0,99,0.00,0.00,0.00