CPT 52318 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 52318 by major payers:
$615.09
$644.54
$691.74
$790.67
| 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 52318 | ||||||
United | 52318 | $819.50 | 1912412420 - GALEA CENTER, LLC., GALEA CENTER FOR ADVANCED SURGERY | 821939476 - (CA) GALEA CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $2353.00 | 1114926714 - ENDOSCOPY CENTER OF DAYTON LTD | 311460799 - (OH) ENDOSCOPY CENTER OF DAYTON LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $2859.00 | 1245605633 - HARBOR HEIGHTS SURGERY CENTER, LLC | 473886948 - (MD) HARBOR HEIGHTS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $1174.00 | 1831280536 - EFFINGHAM SURGICAL PARTNERS LLC | 371409876 - (IL) EFFINGHAM SURGICAL PARTNERS, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $1200.00 | 1710425913 - FLOWOOD VASCULAR ACCESS ASC LLC | 814838440 - (MS) FLOWOOD VASCULAR ACCESS ASC LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $852.89 | 1194834440 - LAURA DIAZ DEL CASTILLO | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 52318 | $2353.00 | 1902302961 - HILL COUNTRY SURGERY CENTER, LLC, SURGERY CENTER OF BOERNE | 352599588 - (TX) HILL COUNTRY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $3495.00 | 1902319478 - CARRIS HEALTH LLC, CENTRACARE WILLMAR SURGERY CENTER | 823166379 - (MN) CARRIS HEALTH LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $748.00 | 1407992878 - WILSON COUNTY EYE SURGERY CENTER, LLC | 621714950 - (TN) WILSON COUNTY EYE SURGERY CENTER, LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $2353.00 | 1871594275 - DESTIN SURGERY CENTER LLC | 593723179 - (FL) DESTIN SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $2353.00 | 1992713176 - DESERT RIDGE OUTPATIENT SURGERY LLC | 202528902 - (AZ) DESERT RIDGE OUTPATIENT SURGERY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $614.00 | 1407993132 - DIGESTIVE DISEASE ENDOSCOPY CENTER | 352597463 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $2388.00 | 1992423719 - ENDOSCOPY ASC OF MIDDLE GEORGIA LLC | 883065469 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $926.00 | 1336138635 - EYE SURGICAL SPECIALISTS OF NEW JERSEY, SURGERY CENTER OF CENTRAL NEW JERSEY | 223411416 - (NJ) EYE SURGICAL SPECIALISTS OF NEW JERSEY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52318 | $1733.00 | 1669426839 - NORTH VALLEY SURGEERY CENTER | 201808351 | 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 52318 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52318 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 52318 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 52318. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52318 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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