2025 CPT code 50553
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Urinary System Surgery Feed
Renal endoscopy through an established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography (excluding radiologic services); with ureteral catheterization, with or without ureteral dilation.
Modifiers may be applicable depending on the circumstances of the procedure.For example, modifier -51 (multiple procedures) could be used if additional procedures were performed during the same session.Always consult the current CPT guidelines and payer-specific policies for guidance on modifier usage.
Medical necessity is established when there is a clinical indication for renal endoscopy, such as evaluation and management of urinary tract obstruction, recurrent infections, or post-surgical complications. The documentation must clearly justify the need for the procedure based on the patient’s symptoms, diagnostic findings, and clinical course.
The clinical responsibility includes pre-operative preparation, anesthesia administration (if applicable), disconnecting and reconnecting the urinary drainage bag, insertion and manipulation of guidewires and endoscopes, irrigation and instillation of fluids (if performed), ureteral catheterization, potential ureteral dilation, and post-operative monitoring.The physician must appropriately document all aspects of the procedure performed.
In simple words: The doctor inserts a thin, flexible tube with a camera (endoscope) into a pre-existing opening in the kidney to examine the kidney and related tubes.They may flush the area with fluid, insert a small drainage tube (catheter), and/or widen any narrowed areas.X-rays taken to view the area are billed separately.
This procedure involves renal endoscopy performed through a pre-existing nephrostomy or pyelostomy tract.The procedure may include irrigation, instillation of fluids, or ureteropyelography (the radiologic study is separately reported).Ureteral catheterization is included, and ureteral dilation may also be performed.The procedure begins with disconnecting the external urinary drainage bag from the nephrostomy or pyelostomy tube. A guidewire is advanced through the tube, and the tube is withdrawn over the wire. The tract may be dilated using surgical instruments. An endoscope is then inserted to examine the kidney, renal pelvis, and ureter.Sterile saline or other therapeutic solutions may be instilled. A catheter is placed and advanced into the ureter, potentially followed by balloon dilation if needed. Finally, the instruments are removed, tubes replaced, and the drainage bag reconnected.
Example 1: A patient presents with recurrent urinary tract infections and hydronephrosis. A nephrostomy tube was placed previously. The urologist performs a renal endoscopy via the nephrostomy tube to assess the cause of obstruction and place a ureteral stent., Following a pyeloplasty, a patient continues to have symptoms of obstruction. The surgeon performs a renal endoscopy through the existing pyelostomy tract to evaluate for residual obstruction and potentially dilate the ureter., A patient with a history of kidney stones undergoes a nephrostomy tube placement.During a follow-up visit, the urologist performs renal endoscopy to assess the collecting system, and remove any remaining stone fragments while simultaneously placing a ureteral catheter.
** The use of imaging guidance (e.g., fluoroscopy) is not inherently included in this code. If image-guidance is used, appropriate codes for those services must be reported separately.Always ensure thorough documentation of the entire procedure and any associated services to support accurate billing and prevent claim denials.
- Revenue Code: P8I (ENDOSCOPY - OTHER)
- RVU: The relative value units (RVUs) for this code vary based on geographic location and other factors.Consult the current Medicare Physician Fee Schedule for the most accurate values.
- Global Days : Global surgical days information is not explicitly provided for this CPT code.Consult official coding guidelines and payer-specific policies for determining the appropriate global period.
- Payment Status: Active
- Modifier TC rule: The technical component (TC) modifier may be applicable if the procedure is performed by different practitioners (e.g., surgeon and anesthesiologist). Review current CPT guidelines and payer policies for details on TC modifier usage.
- Fee Schedule : Historical fee schedule data for this code is not provided, but you can access this data through fee schedule databases from CMS or other relevant sources.
- Specialties:Urology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center