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Official Description

Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

CPT® Code 52352 refers to a specific urological procedure known as cystourethroscopy with ureteroscopy and/or pyeloscopy, which involves the removal or manipulation of a calculus, or stone, located in the ureter or renal pelvis. This procedure is performed using a cystoscope, a specialized instrument that allows for direct visualization of the bladder and ureters. The process begins with the cleansing of the urethra using an antiseptic solution to minimize the risk of infection. A rigid or flexible cystoscope is then introduced through the urethra into the bladder, which may be filled with sterile saline to enhance visibility of the bladder wall. Once the bladder is inspected, the ureters are catheterized to facilitate access to the ureteral stones. A guidewire is advanced through the cystoscope into the ureter, reaching the site of the calculus. The cystoscope is subsequently removed, and a ureteroscope is advanced over the guidewire to the calculus location. During this procedure, the calculus can either be manipulated or removed using a grasping or retrieval device. If removal is not feasible, the calculus may be repositioned within the ureter. This procedure is essential for treating ureteral stones, which can cause significant pain and complications if not addressed. The inclusion of ureteral catheterization in this code indicates that the procedure encompasses the necessary steps to ensure effective access and treatment of the calculus.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 52352 is indicated for the following conditions:

  • Ureteral Calculi The presence of stones in the ureter that may cause obstruction, pain, or other complications.
  • Renal Pelvic Calculi Stones located in the renal pelvis that may require intervention to prevent further complications.
  • Urinary Obstruction Situations where stones are causing blockage in the urinary tract, leading to potential kidney damage or infection.

2. Procedure

The procedure involves several critical steps to ensure effective treatment of the calculus:

  • Step 1: Preparation The patient is positioned appropriately, and the urethra is cleansed with an antiseptic solution to reduce the risk of infection during the procedure.
  • Step 2: Introduction of Cystoscope A rigid or flexible cystoscope is introduced through the urethra into the bladder. Sterile saline may be instilled into the bladder to enhance visualization of the bladder wall.
  • Step 3: Catheterization of Ureters After inspecting the bladder, the ureters are catheterized to allow access to the ureteral stones. This step is crucial for the subsequent manipulation or removal of the calculus.
  • Step 4: Guidewire Advancement A guidewire is introduced through the cystoscope and advanced into the ureter, reaching the site of the calculus located within the ureter or renal pelvis.
  • Step 5: Ureteroscope Advancement The cystoscope is removed, and a ureteroscope is advanced over the guidewire to the site of the calculus. This allows for direct visualization and access to the stone.
  • Step 6: Manipulation or Removal of Calculus The calculus is either manipulated into a different location or removed using a grasping or retrieval device advanced through the ureteroscope. This step is critical for alleviating symptoms and preventing further complications.
  • Step 7: Post-Procedure Care After the calculus has been manipulated or removed, a catheter may be advanced over the guidewire to the renal pelvis. The ureter may be irrigated to clear any fragments of the calculus, and diagnostic or therapeutic solutions may be instilled through the catheter as needed.
  • Step 8: Final Examination The ureteroscope may be advanced into the renal pelvis for a final examination as it is slowly withdrawn, ensuring that no residual stones remain and that the urinary tract is clear.

3. Post-Procedure

Post-procedure care following CPT® Code 52352 involves monitoring the patient for any complications, such as bleeding or infection. Patients may experience some discomfort or hematuria (blood in urine) following the procedure, which is typically temporary. It is essential to provide instructions regarding hydration to help flush out any remaining fragments and to monitor for any signs of urinary obstruction or infection. Follow-up appointments may be necessary to assess the success of the procedure and to determine if further intervention is required.

Short Descr CYSTOURETERO W/STONE REMOVE
Medium Descr CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES
Long Descr Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 3 - Special payment adjustment rules for multiple endoscopic procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Endoscopic Base Code 52351  Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P8E - Endoscopy - cystoscopy
MUE 1
CCS Clinical Classification 101 - Transurethral excision, drainage, or removal urinary obstruction
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GC This service has been performed in part by a resident under the direction of a teaching physician
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
CR Catastrophe/disaster related
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
32 Mandated services: services related to mandated consultation and/or related services (eg, third party payer, governmental, legislative or regulatory requirement) may be identified by adding modifier 32 to the basic procedure.
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
SG Ambulatory surgical center (asc) facility service
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
Date
Action
Notes
2011-01-01 Changed Medium description changed.
2001-01-01 Added First appearance in code book in 2001.
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