CPT 52310 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Urinary System |
| Common Place of Service | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52310 |
National average reimbursement for CPT 52310 by major payers:
$356.16
$366.52
$428.98
$499.38
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 52310 | ||||||
United | 52310 | $443.00 | 1427134998 - HILL COUNTRY MEMORIAL SURGERY CENTER, LLC | 331039828 - (TX) HILL COUNTRY MEMORIAL SURGERY CE | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $458.00 | 1427003904 - PHILADELPHIA WOMEN'S CENTER, INC. | 232476628 - (PA) PHILADELPHIA WOMENS CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $238.47 | 1750474516 - NORTHWEST TEXAS SURGICAL HOSPITAL, LLC, NORTHWEST TEXAS SURGERY CENTER | 233086987 - (TX) NORTHWEST TEXAS SURGICAL HOSPITAL LLC | TX | General Acute Care Hospital (282N00000X) |
United | 52310 | $1936.00 | 1750819025 - NORTH HOUSTON, HCA HOUSTON HEALTHCARE TOMBALL | 821349955 | TX | General Acute Care Hospital (282N00000X) |
United | 52310 | $645.00 | 1346288032 - ENDOSCOPY CENTER AT RIDGE PLAZA LP, ENDOSCOPY CENTER AT MEDPOINT | 383656538 - (TX) ENDOSCOPY CENTER AT MED POINT | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $1390.00 | 1679086078 - CYPRESS CREEK OUTPATIENT SURGICAL CENTER, LLC | 460552249 - (FL) CYPRESS CREEK OUTPATIENT SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $2446.00 | 1932284411 - FOUNDATION BARIATRIC HOSPITAL OF SAN ANTONIO, LLC, FOUNDATION SURGICAL HOSPITAL OF SAN ANTONIO | 203793927 - (TX) FOUNDATION BARIATRIC HOSPITAL OF SAN ANTONIO, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 52310 | $470.00 | 1538153994 - SOUTH FLORIDA CENTER FOR ENDOSCOPY & DIGESTIVE DISEASE LLC, KENDALL ENDOSCOPY & SURGERY CENTER | 651112489 - (FL) SOUTH FLORIDA CENTER FOR ENDOSCOPY & DIGESTIVE DISEASE, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $4922.00 | 1922036805 - DEACONESS HOSPITAL, INC, <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 52310 | $791.00 | 1497090740 - OLOL PONTCHARTRAIN SURGERY CENTER, LLC, OUR LADY OF THE LAKE PONTCHARTRAIN SURGERY CENTER | 461379031 - (LA) OLOL PONTCHARTRAIN SURGERY CENTE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $443.00 | 1750609731 - BELTLINE SURGERY CENTER, LLC | 262639054 - (TX) BELTLINE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $800.00 | 1174568810 - SURGICAL CARE CENTER, INC. | 351640392 - (IN) SURGICAL CARE CENTER INC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $560.00 | 1093993727 - CAROLINA MOUNTAIN GASTROENTEROLOGY ENDOSCOPY CENTER | 261708694 - (NC) CAROLINA MOUNTAIN GASTROENTEROLOGY ENDOSCOPY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $620.00 | 1316190077 - CERRITOS SURGERY CENTER, LLC, CERRITOS SURGERY CENTER, LLC | 651211028 - (CA) CERRITOS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $500.00 | 1225745870 - APOLLO SURGICAL CENTER LLC | 922033557 - (AZ) APOLLO SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 52310 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52310 code is part of the Surgery services used for Surgical Procedures on the Urinary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 52310 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 52300-CPT | Moderate | Cystourethro;Resec Ureterocel,Un/Bi |
| 52301-CPT | Moderate | Cystourethroscopy; With Resection Or Fulguration Of Ectopic Ureterocel |
| 52305-CPT | Moderate | Cystoscopy W Inc/Exc Diverticulum |
| 52310-CPT | Moderate | Cystourethroscopy, With Removal Of Foreign Body, Calculus, Or Ureteral Stent From Urethra Or Bladder (Separate Procedure); Simple |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52310. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52310 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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