Snapshot · 2026-07-29 Public evidence

PUSEN · SINGLE-USE FLEXIBLE URETEROSCOPY · CPT 52356 SIGNAL

Win the right cases first.
Build density from day one.

One field operating system for Utah, Las Vegas, southeast Idaho, and Montana—stack-ranked surgeons, account pathways, an evaluation-led 90-day plan, and an honest value case.

Reportable 2024 provider signal1,199

Original Medicare FFS CPT 52356; not all payer

Reportable surgeons57

178 current urologists in the roster

Ranked accounts368

15 Tier 1 · 21 work now

Assigned regions4

Explicit scope; Las Vegas and southeast Idaho are bounded

FIELD OPERATING PLAN

The first 90 days are an evaluation machine

Qualify the account problem, define the trial, capture structured proof, and connect clinical performance to a local economic decision.

Download business plan PDF
01Days 1–10

Build truth before activity

  • Align with PUSEN on pricing guardrails, evaluation inventory, processor placement, contracting rules, references, and reimbursement claims.
  • Import every assigned account into CRM; deduplicate ownership and suppress active motion before outreach.
  • Validate the top 20 surgeons and top 15 accounts: stone volume, site of care, current reusable/single-use mix, laser/access-sheath compatibility, repair history, reprocessing workflow, and decision roles.
  • Choose six evaluation candidates: two Utah, two Las Vegas, one southeast Idaho, and one Montana, subject to readiness.
ExitTop-35 account map complete; six qualified evaluation candidates; no duplicate ownership.35 account maps · 25 verified surgeon profiles · 6 evaluation candidates
02Days 11–30

Earn evaluations, not generic meetings

  • Run discovery with surgeon plus OR/endoscopy operations; introduce supply chain/value analysis before the trial is scheduled.
  • Use a written evaluation charter: product/model, case types, number of cases, success criteria, data owner, conversion decision, and review date.
  • Lead with the account-specific problem: access/irrigation, suction and visibility, uptime/repair exposure, reprocessing burden, or remote coverage—not a universal disposable claim.
  • Create a competitive baseline from the incumbent scope fleet and actual local cost-per-case inputs.
ExitThree evaluations scheduled with named economic and operational owners.12 discovery meetings · 3 scheduled evaluations · 100% written evaluation charters
03Days 31–60

Convert clinical proof into an economic decision

  • Support cases and capture structured feedback on image, access, deflection, irrigation/suction, setup, turnover, and exceptions.
  • Complete a local value model: device price, reusable capital, repair frequency/cost, reprocessing labor/consumables, downtime, rental, waste, and annual volume.
  • Hold a 48-hour clinical debrief and a seven-day value review after each evaluation block.
  • Advance successful trials into value analysis, contracting, SKU setup, processor placement, and implementation planning.
ExitTwo documented clinical wins and at least one active conversion pathway.15–25 evaluation cases · 2 clinical advocates · 1 value-analysis submission
04Days 61–90

Land anchors and build references

  • Close one anchor account in a dense market and one access/uptime account in a travel market.
  • Create approved local proof: case mix, economic baseline, implementation checklist, and user feedback that can be reused without overclaiming.
  • Expand inside winning groups to affiliated hospitals/ASCs and additional stone surgeons.
  • Reset the territory list using verified conversion probability, not static public volume alone.
ExitTwo anchor implementations or one implementation plus two late-stage conversions.2 anchor pathways · ≥60% evaluation-to-advance rate · 4-account expansion map

ACCOUNT SEQUENCE

Start where volume and leverage meet

Practice activity is assigned surgeon signal. Hospital/ASC activity is linked clinician signal. Neither is direct facility procedure volume.

NON-NEGOTIABLES

What makes an evaluation convert

  1. Problem before productAccess, irrigation, suction/visibility, uptime, reprocessing, or remote coverage.
  2. Three-thread ownershipSurgeon champion, operational owner, economic/purchasing owner.
  3. Written charterModels, case types, success criteria, case count, data owner, decision date.
  4. Local economicsActual device price, repairs, reprocessing, downtime, waste, contracting, and annual cases.
  5. Fast debriefClinical review within 48 hours; value review within seven days.
#1 territory

Utah

539reportable services

Two dense metro loops plus scheduled north and south travel days.

#2 territory

Montana

354reportable services

Hub-and-spoke travel around Billings, Bozeman, Missoula, Kalispell, and Great Falls.

#3 territory

Las Vegas

201reportable services

Cluster evaluations into two- to three-day metro sprints.

#4 territory

Southeast Idaho

105reportable services

One routed corridor trip every four to six weeks, anchored on evaluation-ready sites.

Decision boundary

Public data sequences fieldwork; it does not replace discovery.

Incumbent scopes, all-payer cases, actual site of care, price, contracts, active opportunities, purchasing roles, repair costs, and reprocessing costs are unknown until verified.