Cost analysis for CPT 52356 — Crushing of stone of ureter with insertion of stent using an endoscope
Average Medicare Payment
$440.99
2023 data
Total Payments (2023)
$35.7M
Services (2023)
68.7K
Price Change (2014–2023)
+2.8%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $429.06 | $9.9M | 20.5K | — |
| 2015 | $418.42 | $13.9M | 29.6K | -2.5% |
| 2016 | $418.58 | $18.0M | 38.3K | +0.0% |
| 2017 | $418.23 | $20.4M | 43.5K | -0.1% |
| 2018 | $420.52 | $23.2M | 49.7K | +0.5% |
| 2019 | $427.09 | $27.8M | 57.6K | +1.6% |
| 2020 | $448.07 | $27.0M | 52.7K | +4.9% |
| 2021 | $440.63 | $31.5M | 61.7K | -1.7% |
| 2022 | $434.30 | $32.3M | 63.9K | -1.4% |
| 2023 | $440.99 | $35.7M | 68.7K | +1.5% |
The most expensive state pays 2.9x more than the cheapest for this procedure. MD averages $890.05 vs OK at $303.90.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| MD | $890.05 | $2.5M | 2.8K | 99 |
| CO | $799.48 | $825.1K | 1.0K | 50 |
| OR | $726.63 | $719.4K | 990 | 46 |
| VA | $679.43 | $1.9M | 2.8K | 86 |
| DE | $648.81 | $190.1K | 293 | 12 |
| IA | $645.40 | $757.1K | 1.2K | 45 |
| AK | $642.10 | $152.8K | 238 | 11 |
| CA | $620.09 | $2.2M | 3.6K | 171 |
| MS | $605.50 | $652.7K | 1.1K | 34 |
| ID | $578.27 | $279.3K | 483 | 23 |
| TN | $576.20 | $1.6M | 2.7K | 101 |
| MO | $568.48 | $841.9K | 1.5K | 63 |
| TX | $558.88 | $1.9M | 3.4K | 171 |
| NJ | $554.87 | $1.1M | 2.0K | 99 |
| NV | $540.12 | $258.2K | 478 | 21 |
| FL | $529.12 | $2.6M | 4.9K | 221 |
| IN | $526.92 | $1.2M | 2.2K | 98 |
| IL | $504.31 | $1.5M | 3.0K | 139 |
| GA | $504.27 | $965.7K | 1.9K | 96 |
| WY | $501.01 | $101.7K | 203 | 10 |
| HI | $490.09 | $59.3K | 121 | 8 |
| UT | $483.82 | $332.4K | 687 | 33 |
| KS | $483.79 | $566.0K | 1.2K | 41 |
| MN | $483.11 | $404.8K | 838 | 45 |
| NE | $478.66 | $342.7K | 716 | 35 |
| AZ | $469.57 | $715.1K | 1.5K | 67 |
| PA | $466.25 | $1.5M | 3.2K | 145 |
| NY | $459.52 | $1.3M | 2.8K | 136 |
| OH | $457.25 | $1.4M | 3.1K | 137 |
| SC | $455.67 | $829.3K | 1.8K | 74 |
| NC | $435.88 | $923.2K | 2.1K | 109 |
| WI | $414.71 | $539.1K | 1.3K | 62 |
| AL | $413.09 | $360.2K | 872 | 48 |
| KY | $408.84 | $450.5K | 1.1K | 51 |
| MA | $403.55 | $745.8K | 1.8K | 86 |
| WA | $398.45 | $587.7K | 1.5K | 73 |
| AR | $394.08 | $291.2K | 739 | 34 |
| MT | $386.33 | $160.3K | 415 | 20 |
| DC | $371.35 | $75.8K | 204 | 9 |
| MI | $365.33 | $552.0K | 1.5K | 71 |
| LA | $352.75 | $221.9K | 629 | 31 |
| CT | $339.26 | $206.9K | 610 | 33 |
| NH | $328.00 | $130.2K | 397 | 21 |
| RI | $322.25 | $54.1K | 168 | 10 |
| NM | $322.04 | $82.4K | 256 | 12 |
| ND | $320.58 | $85.0K | 265 | 9 |
| ME | $318.99 | $56.5K | 177 | 10 |
| WV | $312.26 | $130.2K | 417 | 19 |
| VT | $309.91 | $54.9K | 177 | 10 |
| SD | $305.43 | $98.7K | 323 | 14 |
| OK | $303.90 | $269.0K | 885 | 40 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Chesapeake Regional Surgery Center At Virginia Beach, Llc | Ambulatory Surgical Center | VA | $565.8K | 356 | $1589.39 |
| Med Atlantic Inc | Ambulatory Surgical Center | VA | $556.9K | 333 | $1672.46 |
| The Urology Center Llc | Ambulatory Surgical Center | OH | $302.5K | 184 | $1644.08 |
| Urlogy Ambulatory Surgery Center Llc | Ambulatory Surgical Center | TN | $280.9K | 185 | $1518.64 |
| Midlantic Urology Surgery Center, Llc | Ambulatory Surgical Center | PA | $261.3K | 151 | $1730.19 |
| Pasteur Plaza Surgery Center Lp | Ambulatory Surgical Center | TX | $255.9K | 158 | $1619.38 |
| Summit Ambulatory Surgical Center, Llc | Ambulatory Surgical Center | MD | $220.5K | 135 | $1633.52 |
| Oregon Surgicenter Llc | Ambulatory Surgical Center | OR | $207.8K | 116 | $1791.42 |
| Anne Arundel Urological Surgery Center Llc | Ambulatory Surgical Center | MD | $193.3K | 112 | $1725.57 |
| Sutter Bay Medical Foundation | Ambulatory Surgical Center | CA | $186.2K | 73 | $2551.12 |
| Hattiesburg Clinic Pa | Ambulatory Surgical Center | MS | $182.0K | 126 | $1444.30 |
| Mercury Surgery Center Llc | Ambulatory Surgical Center | MO | $169.2K | 102 | $1659.15 |
| Spring Park Surgery Center L L C | Ambulatory Surgical Center | IA | $168.6K | 111 | $1519.32 |
| Uropartners Surgery Center, Llc | Ambulatory Surgical Center | IL | $163.2K | 96 | $1700.44 |
| Dutchess Ambulatory Surgical Center | Ambulatory Surgical Center | NY | $163.1K | 83 | $1965.23 |
| Summit Ambulatory Surgical Center, Llc | Ambulatory Surgical Center | MD | $162.9K | 93 | $1751.43 |
| East Memphis Urology Center, Lp | Ambulatory Surgical Center | TN | $162.6K | 103 | $1579.06 |
| Summit Ambulatory Surgical Center, Llc | Ambulatory Surgical Center | MD | $154.5K | 91 | $1698.22 |
| Urology Surgery Center Of Colorado Llc | Ambulatory Surgical Center | CO | $145.3K | 88 | $1651.20 |
| Aua Surgical Center, Llc | Ambulatory Surgical Center | TX | $143.0K | 92 | $1554.18 |
The data suggests significant pricing inconsistencies for CPT 52356. With a 2.9x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have remained relatively stable over time, but the geographic variation suggests Medicare's geographic adjustment factors may not fully capture the true cost differences across states.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.