Facility-based ureteroscopy or pyeloscopy with kidney or ureteral stone fragmentation using lithotripsy

This code describes a facility-based endoscopic procedure in which a cystourethroscope is advanced through the bladder and into the ureter and/or renal pelvis, with fragmentation of calculi via lithotripsy (typically laser, electrohydraulic, or ultrasonic energy). It is a HCPCS Level II code used by outpatient hospital facilities and ASCs to report this service under the OPPS/APC payment system, distinct from the CPT equivalent used by the performing physician.

Apply this code when a facility is billing for a ureteroscopic or pyeloscopic procedure that includes lithotripsy for ureteral or renal calculi in the hospital outpatient or ASC setting. Supporting documentation should include an operative report confirming endoscopic access to the ureter and/or renal pelvis, the lithotripsy modality used, and stone location. This code is appropriate regardless of whether the scope reached only the ureter, only the renal pelvis, or both, as long as lithotripsy was performed.

• This is a facility-only code; the treating urologist bills the corresponding CPT code (52353) on the professional claim — do not use this HCPCS code on a physician fee schedule claim.
• Distinguish from the ureteroscopy-without-lithotripsy facility code; if lithotripsy is not documented as performed, a different code applies — the operative report must explicitly confirm stone fragmentation.
• When stent placement is also performed during the same session, verify payer policy on whether it is separately reportable or considered bundled under the applicable APC grouping.