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 |
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 | $700.00 | 1972803898 - LAKEVIEW SURGERY CENTER, LLC | 272451566 - (GA) LAKEVIEW SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $509.00 | 1780292110 - BUCKEYE SOUTH LLC, BUCKEYE SURGERY CENTER | 832419523 - (AZ) BUCKEYE SOUTH LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $443.00 | 1245575919 - MEMORIALCARE SURGICAL CENTER AT SADDLEBACK LLC, MEMORIALCARE SURGICAL CENTER LAGUNA WOODS | 203678259 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $1722.00 | 1538262118 - MERCURY SURGERY CENTER LLC | 202045960 - (MO) MERCURY SURGERY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $819.50 | 1740337435 - DIAGNOSTIC AND INTERVENTIONAL SURGICAL CENTER, DIAGNOSTIC AND INTERVENTIONAL SURGICAL CENTER | 342064423 - (CA) DIAGNOSTIC AND INTERVENTIONAL SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $425.00 | 1629135843 - NAEEM M AKHTAR, MADERA AMBULATORY ENDOSCOPY CENTER | 770194609 - (CA) NAEEM M. AKHTAR, M.D. | CA | 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 | $4922.00 | 1922036805 - DEACONESS HOSPITAL, INC, <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 52310 | $443.00 | 1609274505 - BAY AREA SURGICAL SPECIALIST SERVICES, LLC | 471556346 - (CA) BAY AREA SURGICAL SPECIALIST SERVICES LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $1275.00 | 1619166097 - GPDDC, LLC | 43769350 - (NY) GPDDC, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $425.00 | 1821101197 - OLYMPIA MULTI-SPECIALTY CLINIC AMBULATORY PROCEDURES CNTR PLLC | 911703278 - (WA) OLYMPIA MULTISPECIALTY CLINIC AMBULATORY PROCEDURES CNTR PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $1233.00 | 1689664906 - PEDIATRIC SURGERY CENTERS, LLC | 201711553 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $1276.00 | 1396174454 - SURGERY CENTER OF SCOTTSDALE LLC | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $2062.00 | 1093731101 - EAST BRUNSWICK SURGERY CENTER LLC, UNIVERSITY SURGICENTER | 20593133 - (NJ) EAST BRUNSWICK SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52310 | $452.00 | 1003875873 - WILDCREEK SURGERY CENTER | 880377689 | NV | 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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