Summary & Overview
CPT 52352: Cystourethroscopy with Ureteroscopy/Pyeloscopy for Stone Removal
CPT code 52352 represents cystourethroscopy with ureteroscopy and/or pyeloscopy when a ureteral or renal pelvic calculus is identified and removed or manipulated to permit passage or relieve obstruction. This endoscopic urologic procedure is a key intervention for obstructing or symptomatic stones and is commonly performed in hospital outpatient departments and ambulatory surgery centers; it also occurs in inpatient operating rooms when clinically indicated. Nationally, 52352 matters because it captures definitive endoscopic stone management short of laser lithotripsy or percutaneous approaches and therefore aligns with utilization, payment, and quality measurement in urologic stone care.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical indications and typical settings of care, comparisons of payer coverage approaches, common billing and coding considerations, and related code groupings for endoscopic stone procedures. The publication highlights benchmarks and policy context relevant to reimbursement and documentation requirements, while summarizing typical service lines and operational implications for facilities and practitioners. Data not available in the input for payer-specific rates, denied claim patterns, or associated ICD-10 diagnoses are noted as unavailable.
Billing Code Overview
CPT code 52352 describes a cystourethroscopy with ureteroscopy and/or pyeloscopy during which a ureteral or renal pelvic calculus (stone) is found and is removed or manipulated to facilitate passage or relieve obstruction. The procedure involves inspection of the bladder, urethra, prostatic urethra, and ureteric orifices with a cystoscope passed through the urethra into the bladder, followed by endoscopic inspection of the ureters and/or renal pelvis.
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Service type: Endoscopic stone management (cystourethroscopy with ureteroscopy and/or pyeloscopy with stone removal or manipulation)
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Typical site of service: Hospital outpatient department, ambulatory surgery center, or inpatient operating room depending on clinical indications and anesthesia requirements
Clinical & Coding Specifications
Clinical Context
A 52-year-old male presents to the urology clinic with acute left flank pain, hematuria, and nausea. Initial non-contrast CT demonstrates a 6-mm proximal left ureteral calculus with mild hydronephrosis. The patient is scheduled for operative management under general anesthesia in an ambulatory surgery center. During the procedure the surgeon performs a 52352 cystourethroscopy with ureteroscopy/pyeloscopy to visualize the ureter and renal pelvis, identifies the stone, and manipulates or removes the calculus (basket extraction or repositioning) to relieve obstruction and facilitate spontaneous passage. The clinical workflow includes preoperative consent and imaging review, intraoperative cystoscopy and ureteroscopy with possible stone extraction, irrigation and inspection of ureteric orifice and renal pelvis, placement of a ureteral stent if indicated, and postoperative recovery with discharge instructions and follow-up imaging or stent removal as needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Routine reporting when no additional modifier applies |
52 |