CPT 52356 Surgery - Urinary

How Much Does Cysto/uretero with Lithotripsy Cost?

Also known as: Cysto/uretero w/lithotripsy (CPT 52356)

Ureteroscopy, where a thin scope is passed through the urethra and bladder up into the ureter to treat kidney or ureteral stones.

The total estimated cost of Cysto/uretero with Lithotripsy (CPT 52356) is $1,227 to $2,300, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $365.

Total Estimated Cost of Care

$1,227 — $2,300

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$365
Hospital Facility Fee
$1,095
Anesthesia (est.)
$73
Important: The physician fee of $365 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$365
Physician component only — CMS PFS 2026

Patient Guide: Cysto/uretero with Lithotripsy

What you need to know before your appointment

What to Expect

Under anesthesia, a thin scope is passed up through your urinary tract to reach the stone. The surgeon may use a laser to break up the stone and remove fragments. A temporary stent may be placed.

How Long Does It Take?

30-90 minutes

Common Reasons Doctors Order This

Kidney stone removal, ureteral stone removal, stone too large for ESWL, stone not responding to ESWL

How to Prepare

Fast before anesthesia. Arrange a driver. A ureteral stent may cause discomfort for a few days until removed. Drink plenty of fluids after.

Procedures Commonly Done Together

These procedures are frequently performed alongside Cysto/uretero w/lithotripsy

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How to Reduce Your Cost for Cysto/uretero w/lithotripsy

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

7.80
Work RVU
2.11
Practice Expense RVU
1.02
Malpractice RVU
10.93
Total RVU

Payment = Total RVU (10.93) x CF ($33.40) = $365

Frequently Asked Questions

How much does Cysto/uretero w/lithotripsy cost?

The Medicare facility rate for Cysto/uretero w/lithotripsy is $365. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Cysto/uretero w/lithotripsy cost without insurance?

Without insurance, the cost of Cysto/uretero w/lithotripsy can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Cysto/uretero w/lithotripsy?

Most commercial health insurance plans and Medicare cover Cysto/uretero w/lithotripsy when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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