2025 CPT code 50961
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Urinary System - Ureteral Endoscopy Surgery Feed
Ureteral endoscopy through an established ureterostomy to remove a foreign body or calculus.
Modifiers may apply in certain circumstances. For example, modifier 22 (increased procedural service) could be used if the procedure is significantly more complex than usual.Modifiers 51 (multiple procedures) and 59 (distinct procedural service) could apply if performed on the same day as other procedures. Refer to the current CPT manual and payer-specific guidelines for details.
The medical necessity for this procedure is established when a foreign body or calculus is causing symptoms or compromising renal function.Documentation must support the presence of the foreign body or calculus and the clinical indication for removal.
The urologist or surgeon is responsible for performing the endoscopy, irrigation/instillation, and removal of the foreign body or calculus.A radiologist may be involved in the interpretation of any imaging done.
In simple words: This surgery uses a thin, flexible tube (endoscope) inserted through an existing opening in the skin to reach the ureter and kidney. The doctor removes any foreign object or kidney stone found there.Additional imaging may be done, billed separately.
Ureteral endoscopy is performed through a pre-existing ureterostomy (surgical opening connecting the ureter to the skin).The procedure may involve irrigation or instillation, and ureteropyelography (x-ray imaging) may be done. The primary purpose is the removal of a foreign body or calculus (kidney stone) from the ureter, kidney, or renal pelvis.Radiologic services are reported separately.
Example 1: A patient with a pre-existing ureterostomy presents with a kidney stone lodged in the ureter.The urologist performs a ureteral endoscopy through the ureterostomy, removes the stone, and then reinserts the ureterostomy tube., A patient with a ureterostomy has a ureteral obstruction caused by a blood clot.The urologist performs a ureteral endoscopy to irrigate the ureter and remove the clot.Ureteropyelography is not necessary in this case., During a routine follow-up visit for a patient with a ureterostomy, a small fragment of ureteral stent is found. The urologist performs an endoscopy via the existing opening, and removes the fragment under visual guidance.
** Always verify code validity and appropriate use with current coding guidelines and payer-specific policies.The information provided is for reference only and does not constitute medical advice or a substitute for professional coding consultation.Specific reimbursement amounts are subject to payer-specific policies and regulations and may vary depending on location and other factors.
- Revenue Code: P8I (ENDOSCOPY - OTHER)
- RVU: The specific RVUs vary based on geographic location and other factors.Consult the appropriate fee schedule for current values.
- Global Days: The global period will depend on payer-specific guidelines and the specific procedures performed.Clarification is needed to determine the applicable global days.
- Payment Status: Active
- Modifier TC rule: The application of a Technical Component (TC) modifier depends on who performs the procedure. If a physician performs the professional component and a technician or another party performs the technical component, it would be appropriate to use a TC modifier.
- Fee Schedule: Fee schedules vary by payer, geographic location, and year.Consult the relevant fee schedule for historical data.The data provided above represents samples from certain sources.
- Specialties:Urology
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)