CPT 52320 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 52320 by major payers:
$321.12
$335.30
$346.06
$412.84
| 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 52320 | ||||||
United | 52320 | $1062.00 | 1518920040 - COUNTRYSIDE SURGERY CENTER, LTD | 752400186 - (FL) COUNTRYSIDE SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $819.50 | 1447788120 - NORCAL ORTHOPEDIC SURGERY CENTER, LLC | 821046949 - (CA) NORCAL ORTHOPEDIC SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $1710.00 | 1528377678 - NORTH TEXAS TEAM CARE SURGERY CENTER LLC | 271832985 - (TX) NORTH TEXAS TEAM CARE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $2527.00 | 1386161495 - MEDSTAR SURGERY CENTER AT BRANDYWINE, LLC | 820985178 - (MD) MEDSTAR SURGERY CENTER AT BRAN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $2609.00 | 1528104080 - SURGICAL CENTER AT CEDAR KNOLLS LLC | 202158771 - (NJ) SURGICAL CENTER AT CEDAR KNOLLS | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $2924.00 | 1699742676 - PARKWAY SURGERY CENTER, LTD | 364581088 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $4623.00 | 1528438884 - MCLEAN AMBULATORY SURGERY, LLC | 474966649 - (VA) MCLEAN AMBULATORY SURGERY LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $1503.00 | 1649944521 - PRECISION BONE AND JOINT SURGERY CENTER | 861302912 - (FL) PRECISION BONE AND JOINT SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $1861.00 | 1114696234 - ONE NINETEEN GI ASC, LLC | 862162590 - (AL) ONE NINETEEN GI ASC LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $17086.00 | 1225064876 - ROCK HILL SURGERY CENTER, LLC, CAROLINA SURGICAL CENTER | 752562111 - (SC) ROCK HILL SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $1421.00 | 1497733661 - CHEVY CHASE AMBULATORY CENTER LP | 432003978 - (CA) CHEVY CHASE AMBULATORY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $2353.00 | 1861740508 - ADVANCED SURGERY CENTER OF SARASOTA, LLC | 454909647 - (FL) ADVANCED SURGERY CENTER OF SARASOTA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $825.00 | 1871052712 - KURESMART PAIN MANAGEMENT SURGERY CENTER-COLUMBIA LLC, CLEARWAY SURGERY CENTER OF COLUMBIA | 834028893 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTERCOLUMBIA LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $819.50 | 1013138536 - WESTERN WASHINGTON MEDICAL GROUP, INC, PS, DBA: GATEWAY SURGERY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $3473.00 | 1710114293 - RIVERVIEW SURGERY CENTER AT THE NAVY YARD LP | 263910345 - (PA) RIVERVIEW SURGERY CENTER AT THE NAVY YARD LP | 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 52320 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52320 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 52320 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 |
|---|---|---|
| 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) |
| 52320-CPT | Moderate | Cystourethroscopy;Remov Uret.Calc |
| 52325-CPT | Moderate | Cystourethroscopy (Including Ureteral Catheterization); With Fragmentation Of Ureteral Calculus (Eg, Ultrasonic Or Electro-Hydraulic Technique) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52320. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52320 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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