Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple

CPT 52310 is the billing code for "Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple". Cystourethroscopy with simple removal of foreign body, calculus, or ureteral stent

Medicare pays approximately $292.41 for CPT 52310 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 52310 has a total RVU of 7.78, broken down as: Work RVU 3.50, Practice Expense RVU 4.00, and Malpractice RVU 0.28. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 52310 include: Cystoscopy performed documented; Foreign body/calculus/stent removal documented; Method of removal documented; Patient response to procedure. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 52310: Includes cystoscopy and removal. Simple removal Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 52310 include: 59 (Distinct procedural service when multiple procedures performed), 50 (Bilateral procedure). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 52310 is Typically 20-30 minutes. Time-based codes require documentation of the actual time spent providing the service.