CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 52356 RVU and Medicare Payment (2026)
Cysto/uretero w/lithotripsy — 7.8 work RVU, about $365.07 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 7.8
- PE RVU (non-facility)
- 2.11
- PE RVU (facility)
- 2.11
- MP RVU
- 1.02
- Office payment
- $365.07
- Facility payment
- $365.07
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 52356 in a non-facility setting with national GPCI: (7.8 + 2.11 + 1.02) × $33.4009 ≈ $365.07. The same code in a facility setting pays about $365.07 because facility PE RVU (2.11) replaces office PE RVU.
What changes by locality
GPCI moves 52356 non-facility payment from $338.45 to $484.62 across CMS localities — from Nebraska to Alaska. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 52356?
7.8. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 52356 in 2026?
About $365.07 non-facility ($365.07 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (7.8) and malpractice RVU stay fixed; only practice expense changes (2.11 office vs 2.11 facility). That is the entire office-vs-facility payment gap.