2025 CPT code 50081
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Urinary System Surgery Feed
Percutaneous nephrolithotomy or pyelolithotomy for complex kidney stones.
Modifiers 50 (bilateral procedure) and others as clinically indicated (e.g., 22 for increased procedural services).
Medical necessity is established by the presence of symptomatic kidney stones causing pain, infection, or obstruction.The percutaneous approach is chosen for its minimally invasive nature.The complexity of the stones determines the use of 50081.
The surgeon performs a percutaneous antegrade approach to remove kidney stones. This involves creating a small incision, inserting instruments to break and remove the stones, and potentially placing a stent or nephrostomy tube. Imaging guidance is used throughout the procedure.
In simple words: This code describes a complex surgical procedure to remove kidney stones through a small incision in the skin.The surgeon uses imaging to guide instruments to break up and remove large or complex stones from the kidney or ureter. A stent and/or nephrostomy tube may be placed.
Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; complex (e.g., stone(s) > 2 cm, branching stones, stones in multiple locations, ureteral stones, complicated anatomy).
Example 1: A 60-year-old male presents with a large staghorn calculus (kidney stone) extending into the renal pelvis and upper ureter.A percutaneous nephrolithotomy is performed using 50081 because of the size and location of the stone., A 45-year-old female with multiple small, branching stones in both kidneys undergoes bilateral percutaneous nephrolithotomy.Code 50081 is reported with modifier 50 for the bilateral nature of the procedure., A 30-year-old male with a single large kidney stone (3cm) and complicated anatomy requiring multiple access sites undergoes a percutaneous nephrolithotomy. Code 50081 is used because of the stone size and complexity of the anatomy.
Preoperative imaging (e.g., CT scan) showing the size, location, and number of stones; operative report detailing the approach (percutaneous antegrade), techniques used (lithotripsy, stone extraction, ureteroscopy), and placement of any stents or nephrostomy tubes; postoperative imaging to confirm stone clearance.
** This code includes imaging guidance, so a separate code for imaging is not needed.The antegrade approach is emphasized, differentiating it from retrograde procedures.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Urology
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, Outpatient Hospital