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See a sample rate comparisonCPT 52355 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.
Cystouretero W Excise Tumor, Cystourethroscopy With Ureteroscopy And Or Pyeloscopy With Resection Of Ureteral Or Renal Pelvic Tumor
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 52355 |
| Medicaid Fee Schedule | View Medicaid rates for 52355 |
National average reimbursement for CPT 52355 by major payers:
$641.51
$632.72
$666.81
$759.99
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CPT 52355
5 of 25 sample ratesHigher to lower in this preview
Saint Luke'S Surgicenter
Saint Lukes Surgicenter
$4,074.00Published rateMerrimack Valley Endoscopy Center
$2,179.76Published rateUrology Associates Of Central California, Inc, Urology Associates Of Central California Ambulatory Surgical Center
Urology Associates Of Central California Inc
$1,500.00Published rateDelmar Surgical Center LLC
$1,033.00Published rateHayden Surgical Center LLC
$660.00Published rate
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See a sample payer proposalCPT 52355 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52355 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 52355 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 52355. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52355 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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