How much does Medicare pay for CPT 52352?

Medicare allowed an average of $408.05 per service and paid $324.03 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2535.89, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 52352?

Removal or manipulation of stone in ureter or kidney using an endoscope. It was billed 5,368 times to 5,015 Medicare beneficiaries by 284 providers in 2024.

Does 52352 pay differently in an office than a hospital?

Yes. The allowed amount averaged $226.85 in an office setting and $408.42 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 52352 most?

Urology, with 4,223 services from 239 clinicians. Next are Ambulatory Surgical Center, Internal Medicine.

CPT 52352

Removal or manipulation of stone in ureter or kidney using an endoscope

$408.05Medicare-allowed amount per service, averaged across 5,368 services

Providers submitted

$2535.89

Asking price, not received

Medicare allowed

$408.05

The fee schedule figure

Medicare paid

$324.03

Balance is patient coinsurance

Providers submitted an average of $2535.89 for this code and Medicare allowed $408.05 — 6.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $324.03 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $226.85
Hospital / facility: $408.42

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 11 services were billed in an office setting and 5,357 in a facility.

Services: 5,368
Beneficiaries: 5,015
Providers billing it: 284
Total allowed: $2,190,412

What Medicare pays for CPT 52352

Across 5,368 services billed by 284 providers to 5,015 beneficiaries, Medicare allowed an average of $408.05 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 52352

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	4,223	3,957	$213.90	239
Ambulatory Surgical Center	1,124	1,039	$1141.25	44
Internal Medicine	21	19	$207.09	1

52352 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Maryland	816	$430.36	$353.50	22
California	309	$246.34	$154.80	21
New Jersey	295	$316.62	$235.34	17
Pennsylvania	292	$434.42	$348.28	16
Tennessee	280	$674.55	$607.01	14
Florida	258	$400.15	$328.79	17
Indiana	233	$471.61	$391.89	13
Virginia	227	$315.94	$261.56	10
Illinois	213	$486.72	$384.84	11
South Carolina	186	$354.09	$283.56	9
Michigan	179	$159.03	$109.37	9
Texas	175	$504.50	$442.68	10
Massachusetts	167	$202.11	$144.83	10
Mississippi	163	$728.70	$680.70	9
New York	151	$268.21	$177.16	9
Missouri	117	$515.01	$422.03	6
Oklahoma	102	$288.04	$234.09	6
Ohio	101	$760.56	$639.51	5
Arizona	95	$322.97	$258.14	4
Nebraska	90	$459.46	$389.36	6
Alabama	83	$67.09	$41.01	6
Kansas	75	$489.39	$416.38	5
Kentucky	72	$312.17	$253.94	5
Arkansas	68	$476.38	$408.64	5
Oregon	62	$632.81	$483.06	3
Washington	60	$243.84	$187.65	4
Colorado	58	$455.07	$350.81	3
Idaho	52	$834.78	$698.85	3
North Carolina	46	$113.14	$87.58	2
Louisiana	45	$294.93	$241.03	3
Wisconsin	44	$265.18	$207.55	3
Iowa	40	$737.47	$650.19	3
Utah	34	$240.44	$189.36	3
District of Columbia	30	$146.23	$90.87	2
Nevada	27	$947.89	$795.34	2
Georgia	24	$113.92	$76.74	1
New Hampshire	21	$288.26	$215.79	1
North Dakota	16	$318.58	$263.13	1
Montana	14	$285.22	$217.43	1
South Dakota	13	$236.55	$193.78	1
Wyoming	12	$330.06	$256.51	1
West Virginia	12	$353.12	$261.06	1
Delaware	11	$327.79	$259.21	1

Related codes

52332Insertion of stent in ureter$224.05
52356Crushing of stone of ureter$687.05
52310Simple removal of foreign body$344.09
52351Diagnostic exam of bladder$704.52
52353Crushing of stone of ureter$739.44
52317Crushing, fragmenting, and removal of bladder stones, less than 2.5 cm$838.39
52315Complicated removal of foreign body$464.15

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.