Summary & Overview

CPT 52320: Cystourethroscopy with Ureteral Catheterization and Stone Removal

CPT code 52320 represents cystourethroscopy with ureteral catheterization and removal of a ureteral stone, an endoscopic urologic procedure that combines diagnostic visualization of the lower urinary tract with therapeutic stone extraction. This procedure is widely performed in hospital operating rooms and ambulatory surgery centers and is clinically important for relieving ureteral obstruction, resolving pain, and preventing complications such as infection or renal impairment.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national overview of coding and billing context, common service sites, typical clinical indications, and reimbursement and utilization benchmarks where available. Readers will find concise clinical context for appropriate use of CPT code 52320, comparisons of payer coverage tendencies, common billing modifiers, and pointers on documentation elements typically relevant for claim submission.

This resource is intended for billing managers, urology clinicians, and revenue cycle professionals seeking a clear, national-level summary of CPT code 52320 for clinical coding, billing workflow alignment, and payer communication.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare52320CPTurologycystourethroscopyureteral-stone-removalendoscopyambulatory-surgeryoperating-room

Billing Code Overview

CPT code 52320 describes a cystourethroscopy with ureteral catheterization and ureteral stone removal. The procedure involves inspection of the interior of the bladder, the urethra (including the prostatic urethra), and the ureteric orifices using a cystoscope passed through the urethra into the bladder, followed by insertion of a catheter into the ureter and extraction of a ureteral stone.

Service type: Endoscopic urologic procedure for diagnostic visualization and therapeutic removal of ureteral calculi
Typical site of service: Hospital operating room or ambulatory surgery center where endoscopic urologic procedures are performed

Clinical & Coding Specifications

Clinical Context

A 52-year-old male presents to the urology clinic with acute onset right flank pain, microscopic hematuria, and nausea. Non-contrast CT confirms a 6 mm radiopaque calculus lodged in the distal right ureter near the ureterovesical junction. The patient is scheduled for a cystourethroscopy with ureteral catheterization and stone extraction under general anesthesia. In the operating room the patient is positioned supine in lithotomy. A cystoscope is introduced through the urethra to inspect the urethra, prostate urethra, and bladder. The ureteral orifice is identified; a guidewire and ureteral catheter are passed into the right ureter under direct vision, contrast injected to confirm location, and a stone is grasped and removed using appropriate endoscopic instruments. A ureteral stent may be placed at the discretion of the surgeon for drainage. Post-procedure recovery includes monitoring for hematuria, urinary retention, and pain control. Typical documentation includes indication, informed consent, anesthesia record, cystoscopic findings, instruments used, stone retrieved, any stent placement, estimated blood loss, complications, and post-op instructions.

Coding Specifications

Modifier	Description	When to Use
`51`	Multiple procedures	When additional, distinct procedures are billed on the same date by the same provider in addition to this procedure.
`52`	Reduced services	When the cystourethroscopy and stone removal are partially completed or performed in an abbreviated manner.
`53`	Discontinued procedure	When the procedure is initiated but stopped due to patient instability or other valid reasons.
`59`	Distinct procedural service	When a separate, unrelated procedure is performed (e.g., diagnostic cystoscopy plus an unrelated office procedure) on the same day.
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct portions of the procedure.
`78`	Unplanned return to OR following initial procedure	When the patient returns to the OR for a related procedure during the global period.
`79`	(Not in provided list)	Data not available in the input.
`26`	Professional component	When billing only the professional interpretation component separate from technical services.
`TC`	Technical component	When billing only the technical component (equipment, facility) separate from the professional service.
`50`	Bilateral procedure	Rarely applicable; when bilateral ureteral intervention is performed during the same session.
`22`	Increased procedural services	When the procedure involves substantially greater work than usual, documented and justified.
`52`	Reduced services	Duplicate of `52` — use only once in billing when applicable.

Taxonomy Code	Specialty	Notes
`2080S0110X`	Urology	Board-certified urologists commonly perform cystourethroscopy with ureteral stone extraction.
`207L00000X`	General Surgery	Some general surgeons with endourology experience may perform endoscopic urologic procedures.
`2084P0800X`	Pediatric Urology	Pediatric urologists perform analogous cystoscopic procedures in children when indicated.
`2086S0004X`	Gynecologic Urology	Specialists who manage complex lower urinary tract disorders and endoscopic interventions.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N20.1`	Calculus of ureter	Direct indication for ureteral stone removal via cystourethroscopy with ureteral catheterization.
`N20.0`	Calculus of kidney	Associated when a renal stone has migrated to the ureter or requires endoscopic management.
`N13.2`	Hydronephrosis with ureteral stricture	May be present when obstruction from a stone causes upstream dilation prompting intervention.
`R31.0`	Gross hematuria	Symptom that can prompt cystoscopic evaluation and potential stone removal.
`N39.0`	Urinary tract infection, site not specified	Concurrent UTI may be present and documented; care taken perioperatively.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`52000`	Cystourethroscopy (separate procedure code for diagnostic cystoscopy)	May be billed when a diagnostic cystoscopy is performed without ureteral intervention; overlaps in technique but differs by therapeutic extraction element.
`52332`	Cystourethroscopy with ureteroscopy, with removal of ureteral calculus (ureteroscopic stone extraction)	Performed when ureteroscopy is used to visualize and extract ureteral stones; complements or substitutes depending on approach.
`52870`	Ureteral stent placement (with cystoscopic guidance)	Commonly performed following stone extraction to ensure ureteral drainage and prevent obstruction.
`52352`	Cystourethroscopy, with ureteroscopy, with lithotripsy (endoscopic fragmentation of ureteral stone)	Used when stones require intracorporeal lithotripsy prior to removal during the same session.
`52310`	Cystourethroscopy, with insertion of indwelling ureteral stent (retrograde)	Billed when stent placement is the primary intervention and may be done after stone extraction.