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See a sample rate comparisonCPT 52343 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.
Treat Narrowed Urinary Tract, Exam Of The Upper Urinary Tract Using A Scope (Cystourethroscopy). The Procedure Treats A Section Of The Urinary Tract That Has Become Too Narrow For Urine To Flow Freely.
| 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 59 - Distinct Procedural Service LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52343 |
| Medicaid Fee Schedule | View Medicaid rates for 52343 |
National average reimbursement for CPT 52343 by major payers:
$494.17
$476.00
$475.82
$566.79
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CPT 52343
5 of 25 sample ratesHigher to lower in this preview
Iu Health Arnett Hospital, Inc, Arnett Surgery Center, LLC
Indiana University Health Arnett Inc
$10,061.00Published rateSurgcenter Of St. Lucie, LLC
$2,388.00Published rateNorthern Michigan Surgical Suites, LLC
$2,307.00Published rateSurgery Center Of Middle Tennessee LLC, The Surgery Center Of Middle Tennessee
Surgery Center Of Middle Tennessee LLC
$1,262.00Published rateBailey Rankin
Deaconess Hospital Inc
$284.73Published rate
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See a sample payer proposalCPT 52343 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52343 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 52343 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 |
|---|---|---|
| 52341-CPT | Moderate | Treat Narrowed Urinary Tract, Exam Of The Upper Urinary Tract Using A Scope (Cystourethroscopy). The Procedure Treats A Section Of The Urinary Tract That Has Become Too Narrow For Urine To Flow Freely. |
| 52342-CPT | Moderate | Treat Narrowed Urinary Tract, Exam Of The Upper Urinary Tract Using A Scope (Cystourethroscopy). The Procedure Treats A Section Of The Urinary Tract That Has Become Too Narrow For Urine To Flow Freely. |
| 52343-CPT | Moderate | Treat Narrowed Urinary Tract, Exam Of The Upper Urinary Tract Using A Scope (Cystourethroscopy). The Procedure Treats A Section Of The Urinary Tract That Has Become Too Narrow For Urine To Flow Freely. |
| 52344-CPT | Moderate | Treat Narrowed Urinary Tract, Exam Of The Upper Urinary Tract Using A Scope (Cystourethroscopy). The Procedure Treats A Section Of The Urinary Tract That Has Become Too Narrow For Urine To Flow Freely. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52343. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52343 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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