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See a sample rate comparisonCPT 52356 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.
Cysto Uretero W Lithotripsy, Cystourethroscopy With Ureteroscopy And Or Pyeloscopy With Lithotripsy Including Insertion Of Indwelling Ureteral Stent Eg Gibbons Or Double J Type
| 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 52356 |
| Medicaid Fee Schedule | View Medicaid rates for 52356 |
National average reimbursement for CPT 52356 by major payers:
$570.90
$566.21
$607.21
$688.68
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CPT 52356
5 of 25 sample ratesHigher to lower in this preview
Swedish Health Services, Swedish Physician Division
Swedish Health Services
$19,814.66Published rateJessica Dai
$1,156.73Published rateWilliam Duke
Multicare Health System
$895.14Published ratePacific Cataract And Laser Institute, Inc., P.C.
Pacific Cataract And Laser Institute, Inc., PC
$603.33Published rateAlan Bickel
Bronson Battle Creek Hospital
$363.07Published rate
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See a sample payer proposalCPT 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 |
|---|---|---|
| 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). |
| 52356-CPT | Moderate | Cysto Uretero W Lithotripsy, 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.
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