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 |
| Medicare Fee Schedule | View Medicare rates for 52320 |
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 | $1530.00 | 1194960732 - ISURGERY, LLC | 300514883 - (SD) ISURGERY LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $1400.00 | 1992999775 - SPINE SURGERY CENTER OF EUGENE, LLC | 203303351 - (OR) SPINE SURGERY CENTER OF EUGENE LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $1670.00 | 1548842180 - DIGESTIVE HEALTH CENTER LLC | 853810510 - (IA) DIGESTIVE HEALTH CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $2010.00 | 1053336602 - VIRGINIA EYE INSTITUTE INC, VIRGINIA EYE INSTITUTE SURGERY PAVILION | 541420580 - (VA) VIRGINIA EYE INSTITUTE INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $1191.00 | 1902981558 - LANE SURGERY CENTER, LLC | 931305103 - (OR) LANE SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $2406.00 | 1184666364 - LONG ISLAND CENTER FOR DIGESTIVE HEALTH LLC | 364444162 - (NY) LONG ISLAND CENTER FOR DIGESTIVE HEALTH, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $4498.00 | 1659793891 - INOVA AMBULATORY SURGERY CENTER AT LORTON, LLC | 461955980 - (VA) INOVA AMBULATORY SURGERY CENTER AT LORTON LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $2353.00 | 1730175159 - CHARLOTTE ENDOSCOPIC SURGERY CENTER LLC, CHARLOTTE SURGERY CENTER | 651071112 - (FL) CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $678.00 | 1518969773 - ARIZONA SKIN CANCER SURGERY CENTER, P.C. | 562365590 - (AZ) ARIZONA SKIN CANCER SURGERY CENTER PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $854.00 | 1841395621 - BERKELEY ENDOSCOPY CENTER LLC | 383712079 - (SC) BERKELEY ENDOSCOPY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $819.50 | 1659609311 - RIVERLAKES SURGERY CENTER LLC | 270493977 - (CA) RIVERLAKES SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $1806.00 | 1740823848 - KING OF PRUSSIA SURGERY CENTER, LLC, KING OF PRUSSIA SURGERY CENTER | 832782091 - (PA) KING OF PRUSSIA SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $1042.00 | 1124058946 - LUTHERVILLE SURGICENTER, LLC | 522109473 - (MD) LUTHERVILLE SURGICENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52320 | $3993.00 | 1417912098 - BAILEY SQUARE AMBULATORY SURGICAL CENTER, LTD | 752467365 - (TX) BAILEY SQUARE AMBULATORY SURGICAL CENTER LTD | TX | 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 | 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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