Summary & Overview
CPT 52317: Cystourethroscopy with Removal of Small Bladder Stone
CPT code 52317 denotes a simple cystourethroscopy in which a cystoscope is used to inspect the bladder and urethra and to localize, crush, and remove a bladder stone smaller than 2.5 cm. This code captures a common minimally invasive urologic intervention used to relieve obstructive symptoms, address hematuria related to calculi, and prevent recurrent urinary tract complications. Nationally, accurate coding of this procedure affects claims processing, facility and physician payment alignment, and quality measurement for endoscopic stone management. Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and the scope of coverage among major national payers. The publication outlines coding definitions, common use cases, and payer coverage considerations, and it highlights benchmarking and policy updates relevant to endoscopic stone treatment. Data not available in the input is noted where applicable; the content focuses on nationally relevant operational and clinical implications rather than state-specific policy.
Billing Code Overview
CPT code 52317 describes a simple cystourethroscopy with stone localization, crushing, and removal of a small bladder stone under 2.5 cm. The procedure involves use of a cystoscope passed through the urethra into the bladder to inspect the interior of the bladder, the urethra, the prostatic urethra, and the ureteric orifices while localizing and removing a small calculus.
Service type: Operative endoscopic urologic procedure
Typical site of service: Ambulatory surgery center or hospital outpatient department, with some procedures performed in an office setting when appropriate equipment and clinical conditions allow.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 52-year-old male presents to the urology clinic with acute-onset right flank pain and microscopic hematuria. Imaging with non-contrast CT demonstrates a 7 mm distal ureteral stone near the ureterovesical junction. After failed medical management (hydration, analgesics, alpha-blocker) and persistent pain, the urologist schedules a cystourethroscopy with intravesical stone localization and removal. In the ambulatory surgery center under monitored anesthesia care, the provider performs a diagnostic cystourethroscopy, inspects the urethra, prostatic urethra, bladder, and ureteric orifices, identifies the small stone, crushes it with an endoscopic lithotrite, and removes fragments transurethrally. The patient is observed post-procedure for urinary retention and hematuria and discharged home the same day with follow-up instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned (e.g., attempted stone removal but unable to retrieve all fragments). |
53 | Discontinued procedure | Use when procedure is started but stopped due to patient instability or intraoperative findings preventing completion. |