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See a sample rate comparisonCPT 52318 Fee Schedule
Last Verified: October 2026
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.
Litholapaxy Crushing Or Fragm, Litholapaxy Crushing Or Fragmentation Of Calculusby Anymeans In Bladder And Removal Of Fragments Complicated Or Large (Over 2.5 Cm)
| 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 |
| Medicare Fee Schedule | View Medicare rates for 52318 |
| Medicaid Fee Schedule | View Medicaid rates for 52318 |
National average reimbursement for CPT 52318 by major payers:
$615.09
$644.54
$691.74
$772.60
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CPT 52318
5 of 25 sample ratesHigher to lower in this preview
Beltway Surgery Centers, LLC, Meridian South Surgery Center
$8,705.00Published rateCrystal Cities Surgery Center, Twin Cities Surgery Center
$2,206.00Published rateMercer County Surgery Center LLC, Mercer County Surgery Center
Mercer County Surgery Center, LLC
$861.00Published rateWilson County Eye Surgery Center, LLC
$748.00Published rateNatraj Surgery Center Inc.
Natraj Surgery Center Inc
$544.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 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 | Remove Object From Bladder, An Exam Of The Bladder Using A Scope (Cystourethroscopy). The Procedure Includes Removal Of A Foreign Object Stones Or An Implanted Device From The Bladder Or Upper Urinary Tract. |
| 52315-CPT | Moderate | Remove Object From Bladder, An Exam Of The Bladder Using A Scope (Cystourethroscopy). The Procedure Includes Removal Of A Foreign Object Stones Or An Implanted Device From The Bladder Or Upper Urinary Tract. |
| 52317-CPT | High | Litholapaxy Crushing Or Fragm, Litholapaxy Crushing Or Fragmentation Of Calculusby Anymeans In Bladder And Removal Of Fragments Simple Or Small (Less Than 2.5 Cm) |
| 52318-CPT | Moderate | Litholapaxy Crushing Or Fragm, Litholapaxy Crushing Or Fragmentation Of Calculusby Anymeans 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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