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See a sample rate comparisonCPT 52354 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.
Kidney Urinary Tract Biopsy, An Exam Of The Kidneys And Upper Urinary Tract Using A Scope (Cystourethroscopy). The Procedure Includes Removing A Sample Of Tissue For Testing (Biopsy).
| 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 |
| Medicare Fee Schedule | View Medicare rates for 52354 |
| Medicaid Fee Schedule | View Medicaid rates for 52354 |
National average reimbursement for CPT 52354 by major payers:
$547.48
$554.21
$606.00
$671.42
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CPT 52354
5 of 25 sample ratesHigher to lower in this preview
Orange Avenue Surgery Center, LLC
Orange Avenue Surgery Center LLC
$3,567.00Published rateSouth Florida Ambulatory Surgical Center LLC
South Florida Ambulatory Surgi
$2,307.00Published rateMedical City Surgery Center North Texas, LLC
$1,490.00Published rateOlney Endoscopy Center
$1,100.00Published rateDeaconess Hospital, Inc, <Unavail>
Deaconess Hospital Inc
$751.32Published rate
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See a sample payer proposalCPT 52354 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52354 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 52354 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 |
|---|---|---|
| 52352-CPT | Moderate | Cystourethroscopy With Uretero, Cystourethroscopy With Ureteroscopy Andor Pyeloscopy With Removal Or Manipulation Or Calculus (Ureteral Catheterization Is Included) |
| 52353-CPT | Moderate | Remove Urinary Stones, An Exam Of The Urinary Tract And Bladder Using A Scope (Cystourethroscopy). The Procedure Removes Calcium Deposits (Stones). |
| 52354-CPT | Moderate | Kidney Urinary Tract Biopsy, An Exam Of The Kidneys And Upper Urinary Tract Using A Scope (Cystourethroscopy). The Procedure Includes Removing A Sample Of Tissue For Testing (Biopsy). |
| 52355-CPT | Moderate | Cystouretero W Excise Tumor, Cystourethroscopy With Ureteroscopy And Or Pyeloscopy With Resection Of Ureteral Or Renal Pelvic Tumor |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52354. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52354 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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