CPT 52353 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| CMS | $375.22 Physician Fee Schedule |
National average reimbursement for CPT 52353 by major payers:
$556.06
$545.86
$593.29
$664.08
| 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 52353 | ||||||
United | 52353 | $3200.00 | 1598412256 - GEORGIA UROLOGY, PA | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52353 | $5433.00 | 1538461348 - THE OUTPATIENT CENTER, LLC, THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. D/B/A THE OUTPATIENT CENT | 650440864 - (FL) THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52353 | $724.00 | 1235104738 - THE OVERLAND PARK KS ENDOSCOPY ASC LLC, ENDOSCOPIC IMAGING CENTER | 201635603 - (KS) THE OVERLAND PARK KS ENDOSCOPY ASC LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52353 | $4950.00 | 1548870603 - DURANGO SURGERY CENTER LLC, ANIMAS SURGICAL CENTER AT ESCALANTE | 851267666 - (CO) DURANGO SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52353 | $324.29 | 1538346200 - IRTAZA KHAN | 350593390 - DEACONESS HOSPITAL INC | IL | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 52353 | $705.80 | 1720435118 - ELIZABETH TURLEY | 350593390 - DEACONESS HOSPITAL INC | KY | Family Medicine Physician (207Q00000X) |
United | 52353 | $7782.00 | 1275596314 - JOHNSON COUNTY SURGERY CENTER, L.P. | 342029776 - (KS) JOHNSON COUNTY SURGERY CENTER LP | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52353 | $2040.00 | 1841858735 - ELITE AMBULATORY SURGERY CENTER, LLC | 841973218 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52353 | $1933.00 | 1922230853 - CRYSTAL RUN AMBULATORY SURGERY CENTER OF MIDDLETOWN, LLC | 270476822 - (NY) CRYSTAL RUN AMBULATORY SURGERY CENTER OF MIDDLETOWN, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52353 | $1500.00 | 1033214903 - SOUTH HILLS DIAGNOSTIC & TREATMENT CENTER LP, SOUTH HILLS ENDOSCOPY CENTER | 861117604 - (PA) SOUTH HILLS DIAGNOSTIC TREATMENT CENTER LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52353 | $2629.00 | 1225377278 - CENTER FOR MINIMALLY INVASIVE SURGERY PLLC, SOUNDVIEW AMBULATORY SURGERY CENTER | 911661866 - (WA) CENTER FOR MINIMALLY INVASIVE SURGERY, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52353 | $2000.00 | 1174568810 - SURGICAL CARE CENTER, INC. | 351640392 - (IN) SURGICAL CARE CENTER INC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52353 | $2568.00 | 1003575218 - RENAL FOCUS ASC LLC, RENAL FOCUS ASC PLAINVIEW | 863151108 - (NY) RENAL FOCUS ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52353 | $1632.00 | 1891754271 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, DIGESTIVE HEALTH NETWORK ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 52353 | $2108.00 | 1730252487 - J C PITTS ENTERPRISES INC, ONTARIO SURGERY CENTER | 930983555 - (OR) J C PITTS ENTERPRISES INC | OR | 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 52353 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52353 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 52353 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 |
|---|---|---|
| 52351-CPT | Moderate | Cystourethroscopy, With Ureteroscopy And/Or Pyeloscopy; Diagnostic |
| 52352-CPT | Moderate | Cystourethroscopy, With Ureteroscopy And/Or Pyeloscopy; With Removal Or Manipulation Of Calculus (Ureteral Catheterization Is Included) |
| 52353-CPT | Moderate | Cystourethroscopy W Ureteroscpy&/Or Pyeloscopy; With Lithotripsy |
| 52354-CPT | Moderate | Cystourethroscopy With Ureteroscopy And/Or Pyeloscopy; With Biopsy And/Or Fulguration Of Ureteral Or Renal Pelvic Lesion (Desc Rev 01/01/03) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52353. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52353 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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