CPT 52317 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 52317 |
National average reimbursement for CPT 52317 by major payers:
$1,006.38
$1,198.60
$1,307.91
$1,427.21
| 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 52317 | ||||||
United | 52317 | $2688.00 | 1750505756 - SJ MEDICAL CENTER, LLC | 204835578 - (TX) SJ MEDICAL CENTER, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $1100.00 | 1427003904 - PHILADELPHIA WOMEN'S CENTER, INC. | 232476628 - (PA) PHILADELPHIA WOMENS CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $1184.00 | 1841368867 - DUBLIN EYE SURGERY CENTER LLC | 202788445 - (GA) DUBLIN EYE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $1400.00 | 1932136389 - SURGERY CENTER AT 900 N MICHIGAN AVE LLC | 364234488 - (IL) SURGERY CENTER AT 900 N MICHIGAN AVE LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $747.00 | 1902431646 - CENTRAL OHIO ENDOSCOPY CENTER, LLC | 311674561 - (OH) CENTRAL OHIO ENDOSCOPY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $1005.00 | 1790714525 - PLASTIC SURGERY CENTER OF MERIDIAN, LLC | 710898618 - (MS) PLASTIC SURGERY CENTER OF MERIDIAN LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $3995.00 | 1396009346 - PARAMUS ENDOSCOPY LLC, ENDOSCOPY CENTER OF BERGEN COUNTY | 453979491 - (NJ) PARAMUS ENDOSCOPY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $2010.00 | 1295738375 - OREGON SURGICENTER LLC | 431980819 - (OR) OREGON SURGICENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $1735.00 | 1184164816 - DELRAY BEACH SURGICAL SUITES, LLC | 813054776 - (FL) DELRAY BEACH SURGICAL SUITES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $1225.00 | 1417294745 - COAL CREEK AMBULATORY SURGERY CENTER PC, COAL CREEK AMBULATORY SURGERY CENTER | 474079291 - (CO) COAL CREEK AMBULATORY SURGERY CENTER PC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $2388.00 | 1841316841 - PACIFIC ENDOSCOPY CENTER, LLC | 203905706 - (HI) PACIFIC ENDOSCOPY CENTER, LLC | HI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $2307.00 | 1598996894 - SURGICAL ELITE OF AVONDALE, LLC | 270471437 - (AZ) SURGICAL ELITE OF AVONDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $1911.00 | 1942722798 - DREXEL TOWN SQUARE SURGERY CENTER, LLC, DREXEL TOWN SQUARE SURGERY CENTER | 814904300 - (WI) DREXEL TOWN SQUARE SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $1685.00 | 1679531610 - BOSTON UNIVERSITY EYE ASSOCIATES, INC., BOSTON UNIVERSITY EYE ASSOCIATES SURGERY & LASER CENTER | 43137333 - (MA) BOSTON UNIVERSITY EYE ASSOCIATES INC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52317 | $600.00 | 1053417402 - KEYSTONE KIDNEY ASSOCIATES, PC | 232470181 - (PA) KEYSTONE KIDNEY ASSOCIATES PC | PA | 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 52317 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52317 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 52317 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 |
|---|---|---|
| 52310-CPT | Moderate | Cystourethroscopy, With Removal Of Foreign Body, Calculus, Or Ureteral Stent From Urethra Or Bladder (Separate Procedure); Simple |
| 52315-CPT | Moderate | Cystourethroscopy, With Removal Of Foreign Body, Calculus, Or Ureteral Stent From Urethra Or Bladder (Separate Procedure); Complicated |
| 52317-CPT | High | Litholapaxy: Crushing Or Fragmentation Of Calculus By Any Means In Bladder And Removal Of Fragments; Simple Or Small (Less Than 2.5 Cm) |
| 52318-CPT | Moderate | Litholapaxy: Crushing Or Fragmentation Of Calculus By Any Means In Bladder And Removal Of Fragments; Complicated Or Large (Over 2.5 Cm) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52317. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52317 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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