2025 CPT code 50433
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Urinary System Surgery Feed
Percutaneous placement of a nephroureteral catheter, including imaging guidance and radiological supervision.
Modifiers may be applicable depending on the circumstances of the procedure, such as multiple procedures (Modifier 51), bilateral procedures (Modifier 50), or separate structures (Modifier XS).
Medical necessity for a percutaneous nephroureteral catheter placement is established by the presence of a urinary tract obstruction, such as a kidney stone, tumor, or stricture, that requires immediate drainage to prevent urosepsis or renal damage.Documentation must justify the need for this intervention.
The physician is responsible for all aspects of the procedure, including patient preparation, anesthesia administration (if applicable),percutaneous access, catheter placement, imaging guidance (ultrasound/fluoroscopy), image interpretation, and post-procedure care.
In simple words: The doctor inserts a thin tube (catheter) into the kidney and ureter through a small skin puncture to drain urine.This is guided by imaging (ultrasound or X-ray) and includes any necessary kidney and ureter images.
This CPT code, 50433, represents the percutaneous placement of a nephroureteral catheter.The procedure involves creating a new access route into the renal collecting system, inserting a catheter into the kidney and ureter, and connecting it to an external drainage system.Diagnostic nephrostogram and/or ureterogram are included when performed. The code encompasses all radiological supervision, interpretation, and imaging guidance (ultrasound and/or fluoroscopy).
Example 1: A patient presents with a kidney stone causing obstruction of the ureter.A nephroureteral catheter is placed percutaneously to provide drainage and alleviate the obstruction., A patient with renal cancer undergoes nephrectomy. A nephroureteral catheter is placed percutaneously post-operatively for drainage and to monitor for any complications., A patient with a stricture in the ureter is undergoing a ureteroscopy. A nephroureteral catheter is placed percutaneously to facilitate the procedure and to provide postoperative drainage.
Complete medical history, physical examination findings, relevant imaging studies (pre- and post-procedure), operative report detailing the technique, catheter placement confirmation (radiographic or fluoroscopic), and post-operative care instructions.
** The code includes all radiological supervision and interpretation, and imaging guidance (eg, ultrasound and/or fluoroscopy).The renal pelvis and its associated ureter are considered a single entity for reporting purposes.Two separate codes would be reported for bilateral nephrostomy tube placement or for unilateral duplicated collecting system/ureter requiring two separate procedures.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Urology, Radiology, Nephrology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center