Summary & Overview

CPT 0935T: Renal Pelvic Sympathetic Denervation, Radiofrequency Ablation

CPT code 0935T represents a bilateral renal pelvic sympathetic denervation performed endoscopically via the ureter using radiofrequency ablation. The procedure targets renal pelvic sympathetic fibers to reduce renal nerve activity and is carried out with a cystourethroscope, guide wire, ureteral sheath, and fluoroscopic guidance. Nationally, this code is relevant for urology, interventional pain management, and surgical device stakeholders as a specialized minimally invasive renal denervation service.

Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, typical sites of service, and the procedural components represented by the code. The publication outlines billing considerations, common modifiers, and where this service fits within endourology service lines. It also summarizes benchmarks and policy-relevant updates where available.

This summary provides a national perspective on clinical intent and billing classification for 0935T, clarifying the procedure’s scope and typical delivery setting to inform coding, coverage discussion, and operational planning. Data not available in the input is noted where specific payer policies, taxonomies, or ICD-10 pairings would otherwise be listed.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0935TCPTrenal denervationendourologyradiofrequency ablationurogenital proceduresambulatory surgical centerhospital outpatient

Billing Code Overview

CPT code 0935T describes a bilateral renal pelvic sympathetic denervation procedure performed endoscopically through the ureter using a cystourethroscope and radiofrequency ablation. The procedure reduces renal nerve activity by applying radiofrequency energy to the renal pelvic sympathetic fibers and includes placement of a guide wire, insertion of a ureteral sheath, and use of fluoroscopic guidance.

Service Type: Endourologic renal pelvic sympathetic denervation using radiofrequency ablation

Typical Site of Service: Hospital outpatient department or ambulatory surgical center, performed via transureteral access to the kidney under fluoroscopic guidance.

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with treatment-resistant hypertension and documented renal sympathetic overactivity is scheduled for bilateral renal pelvic sympathetic denervation using a cystourethroscope and radiofrequency ablation. The urology or interventional nephrology team performs the procedure in an ambulatory surgical center or hospital catheterization suite under monitored anesthesia care or general anesthesia. The clinician obtains retrograde ureteral access via cystoscopy, inserts a guide wire, and places a ureteral access sheath. Fluoroscopic guidance is used throughout to position the ablation catheter within each renal pelvis. Radiofrequency energy is applied to ablate sympathetic nerve fibers in the renal pelvis to reduce renal nerve signaling. The procedure is billed as a bilateral service under 0935T and includes documentation of laterality, procedural steps (cystourethroscopy, guide wire placement, ureteral sheath insertion, fluoroscopy use, ablation details), anesthesia type, estimated blood loss, complications (if any), and patient disposition for post-procedure monitoring and follow-up blood pressure assessment.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than usual for `0935T` and documentation supports the increased effort.

Taxonomy Code	Specialty	Notes
`2080S00000X`	Urology	Urologists commonly perform cystoscopic access and renal pelvis procedures.
`174400000X`	Interventional Nephrology	Interventional nephrologists may perform renal pelvic ablation procedures.
`207RC0000X`	Radiology - Interventional	Interventional radiologists may assist or perform fluoroscopically guided renal procedures.
`367A00000X`	Anesthesiology	Anesthesiologists provide monitored anesthesia care or general anesthesia for this procedure.
`363L00000X`	Pain Medicine	Pain medicine specialists may be involved when treating refractory hypertension or sympathetically mediated pain.

ICD-10 Code	Description	Clinical Relevance
`I10`	Essential (primary) hypertension	Primary indication when hypertension is treatment-resistant and renal sympathetic denervation is considered.
`I15.0`	Renovascular hypertension	Secondary hypertension due to renal artery stenosis; denervation may be considered in select cases after evaluation.
`I12.9`	Hypertensive chronic kidney disease with stage unspecified chronic kidney disease	Patients with CKD and difficult-to-control hypertension may be candidates for renal denervation after risk assessment.
`N28.9`	Disorder of kidney and ureter, unspecified	Used when a more specific urologic diagnosis is not documented but renal pelvic procedure is performed.
`R33.9`	Retention of urine, unspecified	May be present in patients requiring cystoscopic access or ureteral instrumentation; relevant to perioperative management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`52000`	Cystourethroscopy, with or without irrigation, diagnostic, with or without collection of specimen(s) by brushing or washing	Performed at the procedure start for cystoscopic access to the ureteral orifices and placement of guide wire and sheath prior to `0935T`.
`52010`	Cystourethroscopy, with ureteral catheterization, with or without irrigation and/or instillation; unilateral	Used when diagnostic ureteral catheterization or selective catheter placement is performed during access for the ablation procedure.
`50380`	Renal pelvis endoscopic procedure with removal of obstruction (e.g., incision or incision and dilatation)	May be performed if intrarenal obstruction or anatomy requires correction to permit catheter access for the ablation.
`76000`	Fluoroscopy, up to 1 hour physician time, when performed and documented	Fluoroscopic guidance is integral to positioning and monitoring of the ablation catheter during `0935T` and may be reported per payer rules.
`51798`	Insertion of temporary indwelling ureteral stent (eg, Gibbons or double J); unilateral or bilateral	May be placed post-procedure if ureteral edema or anticipated obstruction requires temporary drainage after `0935T`.
`99024`	Postoperative follow-up visit, minor	Used by some payers for reporting significant postoperative visits related to the procedure when billable.

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