Description of CPT code 52353
52353 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)
The physician examines the urinary collecting system with endoscopes passed through the urethra into the bladder (cystourethroscope), ureter (ureteroscope), and renal pelvis (pyeloscope), and removes or manipulates a stone (calculus). To extract or manipulate a calculus, the physician passes the appropriate surgical instruments through an endoscope to perform the procedure. A ureteral catheter is inserted and the endoscope and instruments are removed.
CPT code 52352 is reported if the physician passes a stone basket through an endoscope to extract or manipulate a calculus. CPT code 52353 is reported if the physician uses an ultrasonic, electrohydraulic, or laser technique to fragment the calculus.
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CPT code 52353 (cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)) should be reported with only one unit of service (UOS) per ureter regardless of the number of calculi in the ureter. If the procedure is performed on bilateral ureters, it may be reported with modifier 50 and one UOS. This code should not be reported with a separate UOS for each calculus.
Cystourethroscopy and transurethral procedures include fluoroscopy when performed. CPT codes describing fluoroscopy or fluoroscopic guidance (e.g. 76000, 77002) should not be reported separately with a cystourethroscopy or transurethral procedure CPT code. (CPT code 76001 was deleted January 1, 2019.)
Related Procedures for CPT code 52353
52351 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic
52352 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)
52354 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion
52355 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor
52356 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)
The parenthetical note following CPT code 52356, Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type), instructs users to not report code 52365 in conjunction with codes 52332 and 52353, when performed on the same side, because the procedure described by code 52356 includes both the insertion of an indwelling ureteral stent (as described by code 52332) and lithotripsy (as described by CPT code 52353).
If the lithotripsy of the additional stone(s) involves significant additional time or physician work, it may be appropriate to append modifier 22, Increased procedural services, to code 52356.
Do not report CPT code 52356 in conjunction with 52332, 52353 when performed together on the same side.
Medicare fees reimbursement rate cost for CPT code 52356
Ambulatory surgical centers – Patient pays (average)$500
Doctor Fee – $393
Facility Fee -$2,111
Total Cost -$2,504
Medicare Pays -$2,003
Hospital outpatient departments -Patient pays (average)$979
Doctor Fee $393
Facility Fee $4,505
Total Cost $4,898
Medicare Pays $3,918
