CPT code 52332 represents one of the highest-volume urology procedure billed to payers. It is called the indwelling ureteral stent code. Due to its large volume, it is the most scrutinized code for urology specialty practices. What decides the payment for this code? There are two factors responsible. Whether the stent was truly indwelling or not is the first factor. Secondly, whether the modifiers match what really happened. This detailed guide shows how to use this code correctly and get accurately paid for services.
What is CPT Code 52332?
The CPT code 52332 description reads cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type). But what does it mean? Let’s understand this. Put simply, the 52332 CPT code description points to a scope procedure that leaves a stent behind. Cystourethroscopy means a thin scope that is passed through urethra into the bladder. Indwelling shows that the stent does not come out, it stays in the patient after the procedure. This word “indwelling” decides which code is used. Gibbons or double-J are stent designs. Sometimes urologists insert a catheter into the ureter during a procedure and it is removed before the patient leaves. For this scenario, CPT 52005 is used, not the 52332.
Does CPT Code 52332 Need a Modifier?
For one ureter, CPT code 52332 does not need a modifier. When there is a change from the default, the modifier jumps in. For example, if another procedure is performed on the same day or an interruption in the procedure.
Bilateral: 50, or LT and RT
The human body has two ureters, one per kidney. CPT code 52332 describes a stent in one of these ureters. If a urologist puts a stent in both, the procedure is done twice. Obviously, you need to explain to the payer about it. Now, payers decide which type of explanation they want. Some payers want one line on the claim with modifier 50 (bilateral) and a quantity of 2. Some payers want two separate lines, one with right (RT) and one with left (LT). Both explain the same thing. You need to follow the format that the payer wants to avoid denials, which is routine work in urology billing services where laterality rules are tracked per payer.
With CPT 52353 on the Opposite Side: 59 or XS
If lithotripsy (breaking the kidney stone) is performed, CPT 52353 is used when it is done through a ureteroscope, without placing a stent. The rule is this: if a surgeon performs lithotripsy on the left ureter and also puts a stent in the same ureter, it will be considered a bundled procedure as part of the lithotripsy by the payer. However, if the lithotripsy is performed on the right ureter and the stent was placed in the left one, it is a separate work and the modifier 59 tells the payer that it is distinct.
The Retrograde Pyelogram: 26 goes on 74420, not on 52332
It is a confusing scenario where the question is: was there imaging and what kind? Two scenarios can occur with the X-ray during a stent placement. The first one: fluoroscopy is used which is a live X-ray to watch the exact position of the stent at that time. This is the part of placing the stent inside and it is not billed separately, it is a part of the CPT 52332.
The second scenario: the surgeon puts a dye into the ureter, takes images, reads them, and writes a report based on the findings. It is a diagnostic study called the retrograde pyelogram. This is a separate service and CPT 74420 is used to bill this service. -26 modifier is used with the 74420 code to show the billing is done on the interpretation of the surgeon, not the machine.
Some guides published this year state that the 52332 descriptor was revised in January 2026 to include imaging and that 74420 now bundles into it. That revision does not appear in the AUA’s list of 2026 urology CPT changes, and the descriptor reads exactly as it did before.
Reduced Services: Modifier 52
This modifier is rarely used with CPT code 52332 as this means reduced service. The work was started but not completed. The note should explain what was done and why the procedure stopped. In this case, there can be scenarios like the wire would not pass or the ureter could not be accessed.
Modifier 58 and 78
CPT 52332 has a 0-day global period, but what does this mean? It means that there is no post-operative window attached to this code. So, these modifiers (58 and 78) rarely apply. Modifier 58 is used when the stent was a planned step in the sequence, for example putting the stent in now and performing lithotripsy in the next week. Modifier 78 is used if the stent was an unplanned return during another procedure’s recovery period.
Billing Bilateral Stents for Five Different Payers?
Some want modifier 50 on one line. Some want LT and RT on two. Bill it the wrong way and one side denies it as a duplicate. We load each payer’s laterality rule into the claim before it’s built.
Get a Free Claim ReviewNCCI Bundling – What CPT Code 52332 Can and Cannot Be Billed With
Here is some information related to bundling the procedures the moment a claim is being created.
| Code | Relationship to 52332 | What to do |
|---|---|---|
| 52356 — ureteroscopy with lithotripsy, including stent | Already contains the stent | Never bill 52332 with it on the same side |
| 52353 — ureteroscopy with lithotripsy, no stent | Bundles a same-side stent | 52332 only with 59 or XS, and only if the stent went in the opposite ureter |
| 52351, 52352, 52354, 52355 | No edit | Bill 52332 alongside, no modifier |
| 52000 — diagnostic cystoscopy | “Separate procedure” designation | Bundles into 52332, never billed alongside |
| 52005 — ureteral catheterization | Bundles when a stent is placed | Not separately billable; a catheter removed the same session is 52005 alone, not 52332 |
| 74420 — retrograde pyelogram | Not bundled when a true diagnostic study is done and documented | Bill 74420, with 26 if the practice doesn’t own the equipment |
| 52310 / 52315 — stent removal | Separate encounter only | Stent exchange in one session is 52332 alone; removal without replacement at a later visit is 52310 or 52315 |
CPT Code 52332 Reimbursement in 2026
Medicare assigns relative value units to the code for the work, the practice expense, and the malpractice risk, then multiplies with a conversion factor and adjusts for geography. CPT 52332 has two rates. The facility versus non-facility discussion is the part specific to this code. The place of service (POS) is the deciding factor which one applies. The non-facility rate is much higher, around two and a half times more than the facility rate. What’s the reason behind it? Keep reading to know this.
If the practice is owned by the physician where the procedure is taking place, the practice supplies everything needed. The staff, scope, room, staff, and the expense, everything was provided by the physician’s own practice. So, reimbursements are higher due to a higher portion of RVUs due to practice expenses. However, if this procedure is done in a hospital or an ASC (Ambulatory Surgery Center), the facility bills separately. The physician now gets paid for the professional work alone.
Practical consequence: Using POS 11 for a procedure that took place in an ASC is an overpayment. Billing POS 24 for done in the physician’s office leaves money on the table. Here’s a small explanation about the conversion factors:
| Year | Conversion factor | Applies to |
|---|---|---|
| 2025 | $32.3465 | All practitioners |
| 2026 | $33.57 | Qualifying alternative payment model participants |
| 2026 | $33.40 | All other practitioners |
One Stent Code, Two Very Different Rates
The place of service on the claim decides whether 52332 pays the office rate or the facility rate, and the gap is large. We check POS against the scheduling record on every urology claim.
Common CPT Code 52332 Denials & How to Prevent Them
Most denials related to 52332 occur due to the differences between the note and the claim. Before we discuss the common denials, here is what the note has to say:
- The indication — why the stent was needed
- Laterality — which ureter, stated in words
- Scope type and approach
- Guidewire use
- Stent type, and that it was left indwelling
- Confirmation of placement
- Provider signature and date
The Denials and How to Prevent Them
- One side, the left or right one, denied as a duplicate claim. The stent went in both ureters but the claim used -50 modifier for a payer that wants RT and LT on two lines. The system of the payer treated the second stent as a repeat procedure of the first. How to prevent it? Record the format each payer wants in your practice management system to build accurate claims.
- 52332 billed with 52356. If the urologist performed lithotripsy and placed a stent on the same ureter, both codes were sent. CPT 52356 already includes the stent part, so the second code is considered a duplicate of the work which is paid. How to prevent it? An efficient claim scrubbing system can help avoid these issues.
- CPT 52332 is bundled into 52353. If the lithotripsy and the stent are on the same side, it is billed as 52353 and 52332 with no modifier. It is a mistake and the stent bundles and pays nothing. If the stent was used on the opposite side, modifier 59 or XS was needed along with a note that mentions the opposite side. How to prevent it? Use accurate coding based on operative notes and never use -59 modifier to break the bundle that note does not support.
- Billing a temporary catheter as 52332 is a problem that invites audits. If the note says that the stent was removed before the patient left, use 52005. Using 52332 is upcoding in this case.
- Using 52000 on the same claim is not the right thing to do. Diagnostic cystoscopy has its own procedure designation and it is bundled in every therapeutic scope code, including this one. Scrubber edits can help prevent this mistake.
- CPT 74420 billed for guidance instead of a diagnostic study. Fluoroscopy which is used to position the stent is part of the CPT 52332. If 74420 is used without any pyelogram separately documented, it is a claim denial. Use 74420 only when a separate imaging report is included in the note.
- Incorrect place of service codes. If the procedure happens in the ASC and the claim says physician’s office, it leads to overpayment or claim denial. How to prevent it? Pulling the POS from the scheduling record, avoid typing it at the time of billing.
Conclusion
The claim denials related to CPT code 52332 are preventable before submission to avoid revenue losses. One thing is important: the 52332 code pays when the stent was indwelling (stays inside after the procedure), the laterality is submitted according to the payer rules and nothing that is part of this code should be separately mentioned in the claim. For accurate claim submissions for this code, reading this guide can help you prevent claim denials. So, use it appropriately based on this reimbursement guide.
Frequently Asked Questions
What is the CPT code 52332 description?
The 52332 CPT code description is cystourethroscopy with the insertion of an indwelling ureteral stent, such as a Gibbons or double-J type. In easy to understand terms, it can be said that there is a scope that goes through the urethra into the bladder. A stent is placed in the ureter to open it and the stent stays there. The stent stays inside and the word “indwelling” is used for this. The most important thing: if the stent is removed during the same visit, 52332 is not used. The “staying in” part of the stent is the crux of this code.
Does CPT code 52332 need a modifier?
If one stent was placed in one ureter, as a normal human body has two ureters. There are three scenarios that require modifiers: if stents were put in both ureters, use modifier 50 on one line or LT and RT on two lines, this format entirely depends on the decision of the payer. If a stone is broken up in one ureter and the stent was placed in the other one, 59 or XS is used. The note must say that the stent was placed on the other side. Notes should match what you send to the payer. Lastly, modifier 26 never goes on 52332 but it is used with 74420 when a separate diagnostic pyelogram was performed and the imaging equipment is not owned by the medical practice.
Can you bill 52332 with 52356 or 52353?
CPT 52332 is not billed with 52356. The reason is the description of each code. The stent is already in the 52356 code. Adding the 52332 code bills the stent twice. The insurance payer denies the claim as duplicate. There is no modifier that can make the claim correct as there was nothing separately happened. So, it becomes an incorrect code combination.
How much does Medicare pay for CPT 52332 in 2026?
There is not a fixed number that we can mention here. Two things changed in 2026 and we can discuss them. The relative value units are multiplied with the conversion factor, the important thing is that 2026 has two conversion factors: $33.57 for practices in a qualifying alternative payment model and $33.40 for everyone else. Further, place of service (POS) codes decide where the procedure actually took place and these codes decide how much physicians are going to get paid. The rate of the physician’s office is much higher than the rate of ASC or hospital because it includes the cost of stent, staff, scope, and the room.
What is the difference between CPT 52332 and 52005?
52005 is used for a catheter which is temporary and it is removed before the patient leaves. CPT code 52332 is used for the stent that stays inside after the patient leaves. If both scenarios occur in one session, only 52332 is billed because the CPT 52005 is included in that code.
