2018 CPT Code for Ureteroscopy

What is the 2018 CPT code for ureteroscopy?

There are many codes that involve a ureteroscopy. It depends on what procedure the surgeon is doing.

Below are the CPT Codes, that include a ureteroscopy:

50575A000Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertion of endopyelotomy stent)
Surgery > Urinary System > Kidney > Endoscopy
52005A000Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;
Surgery > Urinary System > Bladder > Endoscopy-Cystoscopy, Urethroscopy, Cystourethroscopy
52341A000Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)
Surgery > Urinary System > Bladder > Transurethral Surgery > Ureter and Pelvis
52344A000Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)
Surgery > Urinary System > Bladder > Transurethral Surgery > Ureter and Pelvis
52345A000Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)
Surgery > Urinary System > Bladder > Transurethral Surgery > Ureter and Pelvis
52346A000Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)
Surgery > Urinary System > Bladder > Transurethral Surgery > Ureter and Pelvis
52351A000Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic
Surgery > Urinary System > Bladder > Transurethral Surgery > Ureter and Pelvis
52352A000Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)
Surgery > Urinary System > Bladder > Transurethral Surgery > Ureter and Pelvis
52353A000Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)
Surgery > Urinary System > Bladder > Transurethral Surgery > Ureter and Pelvis
52354A000Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion
Surgery > Urinary System > Bladder > Transurethral Surgery > Ureter and Pelvis
52355A000Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor
Surgery > Urinary System > Bladder > Transurethral Surgery > Ureter and Pelvis
52356A000Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)
Surgery > Urinary System > Bladder

Non-Facility Payments for ureteroscopy codes:

National Medicare Non-Facility Payments for the Codes listed above:

50575 – $746.63
52005 – $276.12
52341 – $297.00
52344 – $386.64
52345 – $412.20
52346 – $466.91
52351 – $316.80
52352 – $370.80
52353 – $409.68
52354 – $436.32
52355 – $488.87
52356 – $434.88

Additional Information

From CPT Assistant
May 2014, page 3

Surgery: Urinary System

The guidelines for the Ureter and Pelvis subsection of the Surgery/Urinary System section of the CPT code set were revised to specify that code 52332Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type), may be used in addition to the primary procedure code(s) (52320-5233052334-523525235452355), when reporting the insertion of a self-retaining, indwelling stent performed during diagnostic or therapeutic cystourethroscopy with ureteroscopy and/or pyeloscopy. Please refer to the CPT 2014 code set for other parenthetical notes placed following many of the existing codes in this subsection (eg, 506305170252000523305233252334523435234652351, and 52353).

The parenthetical note following new code 52356Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type), instructs users not to use this code in conjunction with codes 52332 and 52353, since the services described by code 52356 include both the insertion of an indwelling ureteral stent (as described by code 52332) and lithotripsy (as described by code 52353).


What is ureteroscopy?

The National Kidney Foundation describes the ureteroscopy and when it is used. Below is an excerpt from their article titled “Ureteroscopy” in the  A TO Z HEALTH GUIDE:

It is a procedure in which a small scope (like a flexible telescope) is inserted into the bladder and ureter and it is used to diagnose and treat a variety of problems in the urinary tract. For ureteral stones, it allows the urologist to actually look into the ureter, find the stone and remove it. The surgeon passes a tiny wire basket into the lower ureter via the bladder, grabs the stone and pulls the stone free. This is an outpatient procedure with or without a stent inserted (a tube that is placed in the ureter to hold it open).

However, depending on the skill and experience of the surgeon, ureteroscopy can be used for virtually any stone of a size appropriate for it. Fragmentation of stones using helium laser device ureteroscopy is more assured than with shock wave lithotripsy (SWL).

When is ureteroscopy used?

Most often ureteroscopy is used for stones in the ureter, especially for stones closest to the bladder, in the lower half of the ureter. lt is the most common treatment of lower ureteral stones. For stones in the kidney, shock wave lithotripsy (SWL) is the most common treatment. SWL treatment cannot be used in everyone. For patients who are pregnant, morbidly obese, or have a blood clotting disorder, ureteroscopy is a good choice. For very large or oddly shaped stones, or stones that are very hard, other treatments such as percutaneous nephrolithotomy or, rarely, open surgery may be needed.