52352

Removal or manipulation of stone in ureter or kidney using an endoscope

Medicare pricing data for 5,324 providers across 51 states

🤖AI Overview

This procedure has a 5.7x markup — hospitals charge $2,050 but Medicare allows only $358.22. Uninsured patients may face bills 5.7 times higher than what insurance negotiates. Prices vary significantly by location — from $189 in District of Columbia to $590 in Alaska. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Removal or manipulation of stone in ureter or kidney using an endoscope (HCPCS code 52352) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $358.22, but hospitals typically charge $2,050 — a 5.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$71.64

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $358.22, your out-of-pocket cost would be approximately $71.64. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$358.22
Average Hospital Charge
$2,050
Markup Ratio
5.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,050.13
Medicare Allowed$358.22
Medicare Payment$283.64

Hospitals charge 5.7x more than what Medicare allows for this procedure. Medicare actually pays $283.64 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$590$8,1431643+64.7%
Delaware$483$2,6722363+34.9%
Oregon$480$1,93667199+34.1%
Mississippi$473$2,22655386+32.0%
Idaho$458$1,25832138+28.0%
Wyoming$454$2,0331070+26.6%
Tennessee$450$2,174138613+25.5%
Iowa$421$1,60259247+17.6%
Maryland$411$1,948991,109+14.8%
Colorado$408$3,08096279+14.0%
Georgia$408$2,260149513+14.0%
Missouri$399$2,376121526+11.3%
Texas$388$1,9673431,060+8.3%
Indiana$387$2,408160749+8.1%
Nebraska$386$1,84545245+7.7%
Nevada$383$1,5282883+6.8%
Minnesota$381$2,549103304+6.5%
Illinois$381$2,881226991+6.2%
Ohio$380$1,554210857+6.1%
Montana$379$1,41127138+5.9%
Florida$377$1,8423731,311+5.3%
Kansas$376$2,30857316+5.1%
Utah$375$1,83950236+4.6%
Pennsylvania$356$1,582247826-0.5%
South Carolina$355$2,129112539-0.9%
Virginia$342$1,501119503-4.7%
Rhode Island$341$1,0721331-4.7%
New Jersey$339$4,765200816-5.4%
Wisconsin$332$4,706104309-7.4%
California$328$2,3233291,132-8.5%
North Carolina$327$1,439185615-8.8%
New Mexico$324$1,1371840-9.4%
Connecticut$322$2,06382213-10.2%
Louisiana$318$1,27286283-11.3%
Arizona$314$1,621107364-12.4%
New York$312$1,916288802-13.0%
North Dakota$309$1,5371165-13.9%
West Virginia$307$1,2922897-14.2%
New Hampshire$299$2,8473694-16.4%
Washington$293$1,087108315-18.1%
Kentucky$290$1,15868289-18.9%
Oklahoma$288$1,05877390-19.7%
Arkansas$287$92846195-19.8%
Vermont$283$1,5181947-20.9%
Alabama$280$1,39591370-22.0%
Maine$278$9302357-22.4%
Michigan$278$1,082176656-22.4%
Hawaii$276$9041736-23.0%
South Dakota$269$1,11920100-25.0%
Massachusetts$240$1,367131571-33.0%
District of Columbia$189$1,4681154-47.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber