50382 Percutaneous Ureteral Stent CPT Reimbursement | OpenPayer

Summary & Overview

CPT 50382: Percutaneous Ureteral Stent Removal and Replacement

CPT code 50382 identifies a percutaneous, image-guided removal and replacement of an indwelling ureteral stent. This interventional urology procedure is performed when transurethral access is not feasible or when percutaneous access is clinically indicated. The code matters nationally because it captures resource use, facility and professional components, and supports tracking of minimally invasive urinary tract interventions across acute care and outpatient settings.

Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for percutaneous stent exchange, typical sites of service, and payer coverage considerations. The publication summarizes national benchmarks for utilization and reimbursement patterns where available, highlights relevant billing and coding nuances for professional and facility claims, and outlines common clinical scenarios that prompt use of this code.

This summary serves clinicians, billing professionals, and policy analysts seeking an authoritative briefing on coding practice for percutaneous ureteral stent exchange. Data not available in the input is noted where applicable, and the content focuses on national implications rather than state-specific policies.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare50382CPTurologypercutaneous-procedureureteral-stentinterventional-radiologyoutpatient-procedureimage-guided

Billing Code Overview

CPT code 50382 describes a percutaneous procedure to remove and replace an indwelling ureteral stent under imaging guidance. The procedure involves accessing the urinary tract through a percutaneous approach, using fluoroscopic or other imaging techniques to visualize the stent, remove the existing ureteral stent, and insert a replacement stent in the same session.

Service type: Percutaneous interventional urology procedure
Typical site of service: Hospital outpatient department or interventional radiology suite where imaging guidance is available

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with an existing indwelling ureteral stent placed previously for ureteral obstruction from stone disease, ureteral stricture, or post-ureteroscopy management. The patient presents to interventional radiology or a urology procedural suite for removal and replacement of the indwelling ureteral stent because of encrustation, stent malfunction, infection, planned exchange interval, or persistent obstruction. The procedure is performed percutaneously under imaging guidance (fluoroscopy and/or ultrasound) with local anesthesia and conscious sedation or monitored anesthesia care depending on patient comorbidity and complexity.

Typical workflow:

Referral from urology or emergency department for stent exchange or management of stent-related complications.
Pre-procedure evaluation including review of indications, prior imaging, coagulation status, and informed consent.
Patient positioned on fluoroscopy-capable table; sterile percutaneous access to renal collecting system established if needed.
Under imaging guidance, the existing stent is identified, partially withdrawn or removed percutaneously, and a new internal ureteral stent is advanced and positioned across the ureter into the bladder and renal pelvis as indicated.
Completion imaging confirms appropriate stent position and immediate drainage; specimen or urine cultures obtained if infection suspected.
Post-procedure observation, discharge with post-op instructions, and planned urology follow-up for further management or definitive therapy.

Coding Specifications

CPT 50385: Transurethral Ureteral Stent Removal and Replacement

CPT-50386-URETERAL-STENT-REMOVAL-TRANSURETHRAL-IMAGING-GUIDED

CPT 50386: Transurethral Ureteral Stent Removal, Imaging-Guided

CPT-50384-PERCUTANEOUS-URETERAL-STENT-REMOVAL-IMAGE-GUIDED

CPT 50384: Percutaneous Image-Guided Ureteral Stent Removal

Modifier	Description	When to Use
`11`	Country-specific: Normally used to indicate a minor or incidental procedure — (used as a placeholder in this input list)	Use per payer rules when this procedure is the primary/only service and payer requires reporting of usual procedural status.
`22`	Increased procedural services	When work or complexity substantially exceeds typical for `50382` (document rationale).
`26`	Professional component	When professional (physician) interpretation or performance is billed separately from technical component.
`50`	Bilateral procedure	If bilateral percutaneous stent exchanges are performed in the same session (confirm payer bilateral reporting rules).
`51`	Multiple procedures	When `50382` is billed with other unrelated procedures during the same operative session (list other codes).
`52`	Reduced services	When the service is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	If the procedure is started but terminated due to a health risk or other documented reason.
`62`	Two surgeons	When two surgeons from different specialties are required and both perform distinct portions of the procedure.
`76`	Repeat procedure by same physician	When the identical procedure is repeated later the same day by the same physician (not in provided list; excluded).
`78`	Unplanned return to the operating/procedure room for a related procedure during the postoperative period	Use if patient requires an unplanned repeat percutaneous stent exchange related to a complication of the initial `50382` during the global period.
`80`	Assistant surgeon	When a surgical assistant is required and payable by payer policy.
`81`	Minimum assistant surgeon	When a limited assistant role is documented and recognized by payer.

Taxonomy Code	Specialty	Notes
363L00000X	Urology	Urologists commonly request and perform ureteral stent exchanges and manage indications.
1744P0800X	Interventional Radiology	Interventional radiologists commonly perform percutaneous access and image-guided stent exchanges.
207LH0000X	Obstetrics and Gynecology (Urogynecology subgroup not primary)	Rarely involved; included here when pelvic reconstructive surgeons manage complex cases.
208000000X	General Surgery	General surgeons with endourology/interventional skills may participate in select centers.
208000000X	Anesthesiology	Anesthesia providers (monitored anesthesia care) support comfort during the procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N13.2`	Hydronephrosis with ureteral stricture	Common indication when stent exchange is required to relieve obstructive hydronephrosis.
`N20.0`	Calculus of kidney	Nephrolithiasis causing ureteral obstruction or stent placement for stone-related drainage.
`N20.1`	Calculus of ureter	Ureteral stones leading to stent placement or exchange for ongoing drainage.
`N13.6`	Pyonephrosis	Infected obstructed collecting system requiring drainage and stent management.
`T83.198A`	Other mechanical complication of internal prosthetic devices, implants and grafts, initial encounter	Stent encrustation, migration, or malfunction prompting removal and replacement.
`N39.0`	Urinary tract infection, site not specified	Infection associated with indwelling stent requiring exchange and culture-directed therapy.
`N99.89`	Other postprocedural disorders of genitourinary system	Complications after prior procedures necessitating stent management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`50380`	Removal of ureteral stent, cystoscopic	Alternative approach (cystoscopic) to remove a ureteral stent; may be used when percutaneous access is not required.
`50381`	Removal and reinsertion of ureteral stent, cystoscopic	Cystoscopic counterpart for exchange of ureteral stent; performed when antegrade percutaneous access is not needed.
`50240`	Nephrostomy, percutaneous, with catheter placement, including catheter care, replacement, and maintenance	Performed when simultaneous or prior percutaneous renal drainage is required to relieve obstruction before or during stent exchange.
`74475`	Fluoroscopic guidance for needle placement (e.g., for percutaneous access)	Imaging guidance code often reported in conjunction with percutaneous access and stent manipulation under fluoroscopy.
`76937`	Ultrasound guidance for needle placement (e.g., percutaneous access)	Used when ultrasound guidance assists percutaneous renal access during stent exchange.
`52332`	Cystourethroscopy, with insertion of indwelling ureteral stent (without removal of stent)	Endoscopic insertion of ureteral stent when antegrade approach is not used; related in treatment pathway.
`99213`	Office or other outpatient visit for established patient	Typical follow-up or pre-procedure evaluation visit with urology prior to exchange.

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