CPT code 52353 identifies a combined cystourethroscopy with ureteroscopy and/or pyeloscopy in which a urinary calculus is identified and treated with lithotripsy. The procedure encompasses inspection of the bladder, urethra, prostatic urethra, ureteric orifices, ureters, and renal pelvis, followed by fragmentation of stones to facilitate passage or irrigation removal. This code is commonly used for endoscopic management of ureteral and renal pelvic calculi and is relevant to urology practices, ambulatory surgery centers, and hospital surgical departments.

Key payers in national coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and typical sites of service, followed by benchmarking and reimbursement considerations across major payers, coding and billing nuances for procedural reporting, and implications for facility and professional fee splits. The publication also highlights common modifiers used with endoscopic stone procedures and flags where payer-specific policies or prior authorization requirements often apply.

This summary is intended for coding professionals, revenue cycle staff, and clinical leaders seeking a concise reference for CPT code 52353, its clinical scope, and the payer landscape nationally.