CPT 52356 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 | $398.51 Physician Fee Schedule |
National average reimbursement for CPT 52356 by major payers:
$570.90
$566.21
$607.21
$704.48
| 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 52356 | ||||||
United | 52356 | $718.78 | 1740321553 - URGENT MEDICAL CENTER PS | 911732955 - (WA) URGENT MEDICAL CENTER PS | WA | Multi-Specialty Group (193200000X) |
United | 52356 | $503.16 | 1568487627 - RICHARD MYNATT | 814670687 - (WA) SHC MEDICAL CENTER TOPPENISH | TN | Urology Physician (208800000X) |
United | 52356 | $936.27 | 1568824217 - RAND WILCOX VANDEN BERG | 862109896 - DUKE HEALTH INTEGRATED PRACTICE INC | WA | Urology Physician (208800000X) |
United | 52356 | $975.44 | 1720166812 - EUGENE HONG | 911939739 - FRANCISCAN MEDICAL GROUP | WA | Urology Physician (208800000X) |
United | 52356 | $644.76 | 1275064354 - JOSEPH BELLAIRS | 911996643 - (WA) SURGICAL ASSOCIATES NORTHWEST, PC | WA | Student in an Organized Health Care Education/Training Program (390200000X) |
United | 52356 | $1440.40 | 1396841169 - RENGANATHAN SRINIVASAN | 910851599 - THE VANCOUVER CLINIC, INC., PS | WA | Allergy & Immunology Physician (207K00000X) |
United | 52356 | $706.80 | 1851397038 - BRUCE MCCLELLAND | 810421823 - (MT) MISSOULA COMMUNITY HEALTH SERVICES INC | WA | Otolaryngology Physician (207Y00000X) |
United | 52356 | $1003.32 | 1710995295 - REUBEN HUDSON | 912073120 | WA | Urology Physician (208800000X) |
United | 52356 | $895.26 | 1619135738 - DANIEL SIMON | 271209674 | WA | Urology Physician (208800000X) |
United | 52356 | $575.51 | 1699253112 - ADVANCED INTEGRATIVE MEDICINE OF SEATTLE INSTITUTE, PLLC, AIMS INSTITUTE | 831193920 - (WA) ADVANCED INTEGRATIVE MEDICINE OF SEATTLE INSTITUTE PLLC | WA | Multi-Specialty Clinic/Center (261QM1300X) |
United | 52356 | $658.34 | 1285012963 - VANCOUVER SLEEP CENTER, LLC | 473557616 - (WA) VANCOUVER SLEEP CENTER | WA | Multi-Specialty Group (193200000X) |
United | 52356 | $827.83 | 1073554671 - PUBLIC HOSPITAL DISTRICT #1 OF KING COUNTY, VMC PSYCHIATRY AND COUNSELING CENTER | 916000986 - (WA) PUBLIC HOSPITAL DISTRICT 1 OF KING COUNTY | WA | Multi-Specialty Group (193200000X) |
United | 52356 | $587.50 | 1326664921 - MALLORY TROYER | 464254773 - (WA) EYECARE PARTNERS PLLC | WA | Multi-Specialty Group (193200000X) |
United | 52356 | $1189.48 | 1174919633 - RAHOOL DAVE | 910565539 - (WA) VIRGINIA MASON MEDICAL CENTER | WA | Allergy & Immunology Physician (207K00000X) |
United | 52356 | $515.59 | 1982939955 - LINDSAY HAMPSON | 943281666 | WA | Urology Physician (208800000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 52356 vs. Other Surgical Procedures on the Urinary System Codes
The CPT 52356 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 52356 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 |
| 52356-CPT | Moderate | Cystourethroscopy With Ureteroscopy And/Or Pyeloscopy; With Lithotripsy Including Insertion Of Indwelling Ureteral Stent (Eg Gibbons Or Double-J Type) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 52356. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 52356 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 52356) and we'll show you how you compare in 15 minutes or less.