2025 CPT code 50551
Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Urinary System Feed
Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service.
Modifiers may be applicable. Common modifiers used with this code include 22 (Increased Procedural Services), 50 (Bilateral Procedure), 52 (Reduced Services), 59 (Distinct Procedural Service), 73/74 (Discontinued Procedure), and others as appropriate.
After preparing and anesthetizing the patient, the physician disconnects the drainage bag and inserts a guidewire through the nephrostomy/pyelostomy tube, then removes the tube. The opening may be widened, and an endoscope is inserted to examine the renal collecting system. Sterile saline or other solutions may be instilled, and contrast material may be used for radiologic examination (billed separately). Afterward, the instruments are withdrawn, tubes replaced, and the drainage bag reconnected.
In simple words: A flexible tube with a camera is inserted into the kidney through an existing opening to examine the structures inside. This procedure may involve rinsing, adding medication, or taking X-rays of the ureter and renal pelvis (though the X-ray itself is billed separately).
The provider inserts an endoscope through a previously established opening between the collecting system of the kidney and the exterior of the body (nephrostomy) or a previously established opening between the renal pelvis and the exterior of the body (pyelostomy). The kidney, renal pelvis, and ureter are examined. This may include irrigation, instillation, or ureteropyelography, but does not include the radiologic service.
Example 1: A patient with a blocked ureter has a nephrostomy tube placed to drain urine.A follow-up renal endoscopy (50551) is performed through the nephrostomy tract to assess the blockage and determine further treatment., A patient with a kidney stone undergoes a percutaneous nephrolithotomy. Several weeks later, a renal endoscopy (50551) is performed through the established nephrostomy tract to evaluate healing and ensure no remaining stone fragments., A patient with a kidney infection has a pyelostomy tube placed. A renal endoscopy (50551) is performed through the pyelostomy tract to assess the infection's extent and guide treatment.
Documentation should include details about the existing nephrostomy or pyelostomy, the reason for the endoscopy, findings during the procedure, any instilled solutions, and whether ureteropyelography was performed (with the understanding that the radiology service is billed separately).
- Specialties:Urology, Nephrology, Interventional Radiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center